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Surgical outcomes of perihilar cholangiocarcinoma based on the learning curve of a single surgeon at a tertiary academic hospital: A retrospective study

 Hye Jeong Park  ;  Dai Hoon Han  ;  Gi Hong Choi  ;  Jin Sub Choi 
 Annals of Hepato-biliary-pancreatic Surgery, Vol.25(1) : 54-61, 2021-02 
Journal Title
Annals of Hepato-biliary-pancreatic Surgery
Issue Date
Learning curve ; Perihilar cholangiocarcinoma ; Surgical outcome
Backgrounds/aims: Although it is difficult to master the surgical learning curve for treatment of perihilar cholangiocarcinoma (HCCA), there have been no studies on surgical outcomes between a novice and an experienced surgeon. Thus, the current study attempted to evaluate surgical outcomes from a single surgeon based on learning curve for surgical treatment of HCCA.

Methods: From January 2008 to December 2016, a single surgeon performed surgical treatment for 108 patients with HCCA at Severance Hospital, Seoul, Korea. Among them, 101 patients with curative surgical resection were included in this study. The learning curve was assessed by a moving average graph and CUSUM method using operation time. Surgical outcomes between the early period group (EPG) and the late period group (LPG) were compared according to learning curve.

Results: Operation time (603.17±117.59 and 432.03±91.77 minutes; p<0.001), amount of bleeding during operation (1127.86±689.54 and 613.05±548.31 ml; p<0.001), and severe complication rates (47.6% and 27.1%, p=0.034) were significantly smaller in the LPG. There was no significant difference in R0 resection rate (85.7% and 76.3%; p=0.241) as well as long-term survival rate.

Conclusions: In this study, operation time, amount of bleeding during operation, length of hospital stay, and severe complication rate were improved after stabilization of the learning curve. However, R0 resection rate and survival outcomes were not significantly influenced by the learning curve for surgical treatment of HCCA.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Hye Jeong(박혜정)
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
Han, Dai Hoon(한대훈) ORCID logo https://orcid.org/0000-0003-2787-7876
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