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Validation of the board certification system for expert surgeons (hepato‐biliary‐pancreatic field) using the data of the National Clinical Database of Japan: part 1 ‐ Hepatectomy of more than one segment
Author(s) -
Miura Fumihiko,
Yamamoto Masakazu,
Gotoh Mitsukazu,
Konno Hiroyuki,
Fujimoto Jiro,
Yanaga Katsuhiko,
Kokudo Norihiro,
Yamaue Hiroki,
Wakabayashi Go,
Seto Yasuyuki,
Unno Michiaki,
Miyata Hiroaki,
Hirahara Norimichi,
Miyazaki Masaru
Publication year - 2016
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.344
Subject(s) - certification , medicine , hepatectomy , board certification , logistic regression , general surgery , database , surgery , medical education , management , continuing medical education , continuing education , computer science , resection , economics
Background The objective of this study was to validate the board certification system of the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery (JSHBPS) using the data of hepatectomy cases from the National Clinical Database (NCD) of Japan. Methods Minimal required annual numbers of high‐level hepato‐biliary‐pancreatic (HBP) surgeries were 50 for a board‐certified A training institution and 30 for a board‐certified B training institution. Records of 14,970 patients who had undergone hepatectomy of more than one segment (MOS), excluding lateral segmentectomy, during 2011 and 2012 were analyzed according to the category of board‐certified institution and with or without participation of board‐certified instructors or expert surgeons. Results Thirty‐day mortality and operative mortality of 14,970 patients after MOS hepatectomy were 1.9% and 3.8%, respectively. Operative mortality rates after MOS hepatectomies performed at certified A institutions, certified B institutions, and non‐certified institutions were 3.1%, 3.8%, and 4.5%, respectively ( P < 0.001). The operative mortality rates after MOS hepatectomies performed with participation of certified instructors or expert surgeons were better than those without (3.5% vs. 4.3%, P = 0.012). A multiple logistic regression model showed that the cutoffs of high‐level HBP surgeries performed per year at hospitals that predicted operative mortality after MOS hepatectomies were 10 and 50. Conclusions Competences and requirements for board‐certified institutions, instructors, and expert surgeons to perform hepatectomy were found to be appropriate.