Liver surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it

Guido Torzilli, Luca Viganò, Felice Giuliante, Antonio Daniele Pinna

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

During the last decades, liver surgery had an extraordinary evolution and diffusion thanks to a drastic reduction of operative mortality and morbidity rates. A debate is ongoing about the need for centralization of liver resections in tertiary referral centers. Robust evidences showed that complex surgical procedures have lower mortality rates when performed in high-volume centers. The present expert group reviewed the literature data and proposed guidelines to identify surgical units that should be entitled to perform liver surgery in Italy. Three separate types of requirements were identified. First, the hospital requirements that include the following criteria: (1) a hospital of 1st level according to the Italian law; (2) the presence of a dedicated hepatobiliary or hepatobiliopancreatic unit or a team dedicated to liver surgery into a general surgery unit; (3) the mandatory presence of oncology, hepatology, radiology, interventional radiology, digestive endoscopy, intensive care, and pathology units; (4) the availability of a liver transplant team into the hospital or into another hospital within an established partnership; (5) a periodic multidisciplinary meeting. Second, the volume requirements: the unit has to perform more than 20 liver resections per year for malignant liver diseases with a 90-day mortality rate 

Original languageEnglish
Pages (from-to)135-142
Number of pages8
JournalUpdates in Surgery
Volume68
Issue number2
DOIs
Publication statusPublished - Jun 1 2016

Fingerprint

Hospital Units
Italy
Referral and Consultation
Liver
Mortality
Interventional Radiology
Gastroenterology
Radiology
Tertiary Care Centers
Endoscopy
Intensive Care Units
Liver Diseases
Guidelines
Pathology
Morbidity
Transplants

Keywords

  • Centralization
  • Hospital volume
  • Liver surgery
  • Minimal requirements
  • Mortality and morbidity
  • Multidisciplinary team

ASJC Scopus subject areas

  • Surgery

Cite this

Liver surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it. / Torzilli, Guido; Viganò, Luca; Giuliante, Felice; Pinna, Antonio Daniele.

In: Updates in Surgery, Vol. 68, No. 2, 01.06.2016, p. 135-142.

Research output: Contribution to journalArticle

@article{87a42f17de7f4df1b73284e9ffdd90b6,
title = "Liver surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it",
abstract = "During the last decades, liver surgery had an extraordinary evolution and diffusion thanks to a drastic reduction of operative mortality and morbidity rates. A debate is ongoing about the need for centralization of liver resections in tertiary referral centers. Robust evidences showed that complex surgical procedures have lower mortality rates when performed in high-volume centers. The present expert group reviewed the literature data and proposed guidelines to identify surgical units that should be entitled to perform liver surgery in Italy. Three separate types of requirements were identified. First, the hospital requirements that include the following criteria: (1) a hospital of 1st level according to the Italian law; (2) the presence of a dedicated hepatobiliary or hepatobiliopancreatic unit or a team dedicated to liver surgery into a general surgery unit; (3) the mandatory presence of oncology, hepatology, radiology, interventional radiology, digestive endoscopy, intensive care, and pathology units; (4) the availability of a liver transplant team into the hospital or into another hospital within an established partnership; (5) a periodic multidisciplinary meeting. Second, the volume requirements: the unit has to perform more than 20 liver resections per year for malignant liver diseases with a 90-day mortality rate ",
keywords = "Centralization, Hospital volume, Liver surgery, Minimal requirements, Mortality and morbidity, Multidisciplinary team",
author = "Guido Torzilli and Luca Vigan{\`o} and Felice Giuliante and Pinna, {Antonio Daniele}",
year = "2016",
month = "6",
day = "1",
doi = "10.1007/s13304-016-0373-0",
language = "English",
volume = "68",
pages = "135--142",
journal = "Updates in Surgery",
issn = "2038-131X",
publisher = "Springer-Verlag Italia",
number = "2",

}

TY - JOUR

T1 - Liver surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it

AU - Torzilli, Guido

AU - Viganò, Luca

AU - Giuliante, Felice

AU - Pinna, Antonio Daniele

PY - 2016/6/1

Y1 - 2016/6/1

N2 - During the last decades, liver surgery had an extraordinary evolution and diffusion thanks to a drastic reduction of operative mortality and morbidity rates. A debate is ongoing about the need for centralization of liver resections in tertiary referral centers. Robust evidences showed that complex surgical procedures have lower mortality rates when performed in high-volume centers. The present expert group reviewed the literature data and proposed guidelines to identify surgical units that should be entitled to perform liver surgery in Italy. Three separate types of requirements were identified. First, the hospital requirements that include the following criteria: (1) a hospital of 1st level according to the Italian law; (2) the presence of a dedicated hepatobiliary or hepatobiliopancreatic unit or a team dedicated to liver surgery into a general surgery unit; (3) the mandatory presence of oncology, hepatology, radiology, interventional radiology, digestive endoscopy, intensive care, and pathology units; (4) the availability of a liver transplant team into the hospital or into another hospital within an established partnership; (5) a periodic multidisciplinary meeting. Second, the volume requirements: the unit has to perform more than 20 liver resections per year for malignant liver diseases with a 90-day mortality rate 

AB - During the last decades, liver surgery had an extraordinary evolution and diffusion thanks to a drastic reduction of operative mortality and morbidity rates. A debate is ongoing about the need for centralization of liver resections in tertiary referral centers. Robust evidences showed that complex surgical procedures have lower mortality rates when performed in high-volume centers. The present expert group reviewed the literature data and proposed guidelines to identify surgical units that should be entitled to perform liver surgery in Italy. Three separate types of requirements were identified. First, the hospital requirements that include the following criteria: (1) a hospital of 1st level according to the Italian law; (2) the presence of a dedicated hepatobiliary or hepatobiliopancreatic unit or a team dedicated to liver surgery into a general surgery unit; (3) the mandatory presence of oncology, hepatology, radiology, interventional radiology, digestive endoscopy, intensive care, and pathology units; (4) the availability of a liver transplant team into the hospital or into another hospital within an established partnership; (5) a periodic multidisciplinary meeting. Second, the volume requirements: the unit has to perform more than 20 liver resections per year for malignant liver diseases with a 90-day mortality rate 

KW - Centralization

KW - Hospital volume

KW - Liver surgery

KW - Minimal requirements

KW - Mortality and morbidity

KW - Multidisciplinary team

UR - http://www.scopus.com/inward/record.url?scp=84975883348&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84975883348&partnerID=8YFLogxK

U2 - 10.1007/s13304-016-0373-0

DO - 10.1007/s13304-016-0373-0

M3 - Article

VL - 68

SP - 135

EP - 142

JO - Updates in Surgery

JF - Updates in Surgery

SN - 2038-131X

IS - 2

ER -