• Fumihiko Miura, Masakazu Yamamoto, Mitsukazu Gotoh, Hiroyuki Konno, Jiro Fujimoto, Katsuhiko Yanaga, Norihiro Kokudo, Hiroki Yamaue, Go Wakabayashi, Yasuyuki Seto, Michiaki Unno, Hiroaki Miyata, Norimichi Hirahara, and Masaru Miyazaki.
• Committee of the Board Certification System for Expert Surgeons, Japanese Society of Hepato-Biliary-Pancreatic Surgery, Tokyo, Japan.
• J Hepatobiliary Pancreat Sci. 2016 Jun 1; 23 (6): 353-63.

BackgroundData of pancreatoduodenectomy (PD) cases from the National Clinical Database (NCD) were analyzed in order to validate the board certification system established by the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS).MethodsBoard-certified A training institutions and board-certified B training institutions were required to perform at least 50 and 30 high-level hepato-biliary-pancreatic (HBP) surgeries per year, respectively. Records of 17,563 patients who had undergone PD during 2011 and 2012 were retrospectively analyzed according to the category of the board-certified institution and with or without participation of board-certified instructors or expert surgeons.ResultsOperative mortality rates after PDs performed at certified A institutions, certified B institutions, and non-certified institutions were 1.5%, 3.0%, and 3.9%, respectively (P < 0.001). The operative mortality rates after PDs performed with participation of certified instructors or expert surgeons were better than those without (2.2% vs. 3.8%, P < 0.001). A multiple logistic regression model showed that cutoffs of high-level HBP surgeries performed per year at hospitals that predicted 30-day mortality after PDs were 10 and 50, and that those that predicted operative mortality were 10 and 70.ConclusionsThe requirements for board-certified institutions, instructors, and expert surgeons to perform PD were appropriate. The requirements for board-certified A institutions were close to the identified cutoffs. Further analyses are necessary to elucidate the implications of the board certification system.© 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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