Whipple’s operation with a modified centralization concept: A model in low-volume Caribbean centers

Table 2 Summary of studies comparing peri-operative mortality according to surgeon volumes

Author	Peri-operative mortality		P	Study population	Definition of low-volume surgeon	Definition of high-volume surgeon
	Low volume surgeon, %	High volume surgeon, %
Lieberman et al[2], 1995	15.5	4.7	< 0.001	2233 PDs over 8 years in New York State	< 9 cases experience	> 41 cases experience
Sosa et al[3], 1998	12	1.8	< 0.001	449 PDs + 47 total pancreatectomies from non-federal facilities in Maryland, USA	< 5 PD annually	> 50 PD annually
Nordback et al[13], 2002	14	3	< 0.05	350 PDs in 33 hospitals by 98 surgeons	< 1 annually	> 3 annually
Schmidt et al[1], 2010	4	2	0.09	1003 PDs at Indiana University across 2 periods	< 20 annually	> 20 PD annually
Eppsteiner et al[35], 2009	6.4	2.4	< 0.0001	3581 pancreatic resections from the National Inpatient Sample Database	< 5 annually	≥ 5 annually

PD: Pancreatico-duodenectomy.