Implementation and first results of a mandatory, nationwide audit on liver surgery

Leonie R. van der Werf, Niels F. M. Kok, Carlijn I. Buis, Dirk J. Grünhagen, Frederik J. H. Hoogwater, Rutger Jan Swijnenburg, Marcel den Dulk, Kees C. H. C. Dejong, Joost M. Klaase, Marieke T. de Boer, Marc G. H. Besselink, Thomas M. van Gullik, Jeroen Hagendoorn, Richard van Hillegersberg, Mike S. L. Liem, I. Quintus Molenaar, Gijs A. Patijn, Robert J. Porte, Wouter W. te Riele, Hjalmar C. van SantvoortKees Verhoef, Marc C. Burgmans, Otto M. van Delden, Christiaan van der Leij, Martijn R. Meijerink, Adriaan Moelker, Warner Prevoo, Dutch Hepato Biliary Audit Group

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Background: The Dutch Hepato Biliary Audit (DHBA) was initiated in 2013 to assess the national quality of liver surgery. This study aimed to describe the initiation and implementation of this audit along with an overview of the results and future perspectives. Methods: Registry of patients undergoing liver surgery for all primary and secondary liver tumors in the DHBA is mandatory. Weekly, benchmarked information on process and outcome measures is reported to surgical teams. In this study, the first results of patients with colorectal liver metastases were presented, including results of data verification. Results: Between 2014 and 2017, 6241 procedures were registered, including 4261 (68%) resections for colorectal liver metastases. For minor- and major liver resections for colorectal liver metastases, the median [interquartile range] hospital stay was 6 [4–8] and 8 [6–12] days, respectively. A postoperative complicated course (complication leading to >14 days of hospital stay, reintervention or death) occurred in 26% and 43% and the 30-day/in-hospital mortality was 1% and 4%, respectively. The completeness of data was 97%. In 3.6% of patients, a complicated postoperative course was erroneously omitted. Conclusion: Nationwide implementation of the DHBA has been successful. This was the first step in creating a complete evaluation of the quality of liver surgery.
Original languageEnglish
Pages (from-to)1400-1410
Issue number10
Publication statusPublished - 1 Oct 2019

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