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Article

Effect of Volume on Postoperative Outcomes After Left Pancreatectomy: A Multicenter Prospective Snapshot Study (SPANDISPAN Project)

by
Daniel Aparicio-López
1,†,
José M. Ramia
2,3,4,†,
Celia Villodre
2,3,4,
Juan J. Rubio-García
2,3,
Belén Hernández
5,
Juli Busquets
6,
Luis Secanella
6,
Nuria Peláez
6,
Maialen Alkorta
7,
Itziar de-Ariño-Hervás
7,
Mar Achalandabaso
8,
Enrique Toledo-Martínez
8,
Fernando Rotellar
9,
Pablo Martí-Cruchaga
9,
Miguel A. Gómez-Bravo
10,
Gonzalo Suárez-Artacho
10,
Marina Garcés-Albir
11,
Luis Sabater
11,
Gabriel García-Plaza
12,
Francisco J. Alcalá
12,
Enrique Asensio
13,
David Pacheco
13,
Esteban Cugat
14,
Francisco Espín
14,
María Galófre-Recasens
14,
Belinda Sánchez-Pérez
15,
Julio Santoyo-Santoyo
15,
Jorge Calvo
16,
Carmelo Loinaz
16,
María I. García-Domingo
17,
Santiago Sánchez-Cabús
18,
Belén Martín-Arnau
18,
Gerardo Blanco-Fernández
19,
Isabel Jaén-Torrejimeno
19,
Carlos Domingo-del-Pozo
20,
Carmen Payá
20,
Carmen González
21,
Eider Etxebarría
21,
Rafael López-Andújar
22,
Cristina Ballester
22,
Ana B. Vico-Arias
23,
Natalia Zambudio-Carroll
23,
Sergio Estévez
24,
Manuel Nogueira-Sixto
24,
José I. Miota
25,
Belén Conde
25,
Miguel A. Suárez-Muñoz
26,
Jorge Roldán-de-la-Rua
26,
Angélica Blanco-Rodríguez
27,
Manuel González
27,
Pilar E. González-de-Chaves-Rodríguez
28,
Betsabé Reyes-Correa
28,
Santiago López-Ben
29,
Berta Tió
29,
Javier Mínguez
30,
Inmaculada Lasa-Unzué
30,
Alberto Miyar
31,
Lorena Solar
31,
Fernando Burdío
32,
Benedetto Ielpo
32,
Alberto Carabias
33,
María P. Sanz-Muñoz
33,
Alfredo Escartín
34,
Fulthon Vela
34,
Elia Marqués
35,
Adelino Pérez
35,
Gloria Palomares
36,
Antonio Calvo-Córdoba
36,
José T. Castell
37,
María J. Castro
38,
María C. Manzanares
39,
Enrique Artigues
40,
Juan L. Blas
41,
Luis Díez
42,
Alicia Calero
43,
José Quiñones
44,
Mario Rodríguez
45,
Cándido F. Alcázar-López
2,3,4,* and
Mario Serradilla-Martín
23,46
add Show full author list remove Hide full author list
1
Department of Surgery, Hospital Universitario San Jorge, 22004 Huesca, Spain
2
Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain
3
ISABIAL, 03010 Alicante, Spain
4
Department of Surgery, School of Medicine, Miguel Hernández University, 03202 Alicante, Spain
5
Department of Surgery, Hospital General Universitario de Elda, 03600 Alicante, Spain
6
Department of Surgery, Hospital Universitario de Bellvitge, 08907 Barcelona, Spain
7
Department of Surgery, Hospital Universitario de Donostia, 20014 San Sebastián, Spain
8
Department of Surgery, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
9
Department of Surgery, Clínica Universidad de Navarra, 31008 Pamplona, Spain
10
Department of Surgery, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
11
Department of Surgery, Hospital Clínico Universitario, University of Valencia, Biomedical Research Institute, 46010 Valencia, Spain
12
Department of Surgery, Hospital Insular de Gran Canaria, 35016 Las Palmas, Spain
13
Department of Surgery, Hospital Universitario Río Hortega, 47012 Valladolid, Spain
14
Department of Surgery, Hospital Universitario German Trias i Pujol, 08916 Badalona, Spain
15
Department of Surgery, Hospital Regional Universitario, 29010 Málaga, Spain
16
Department of Surgery, Hospital Universitario Doce de Octubre, 28041 Madrid, Spain
17
Department of Surgery, Hospital Mutua de Tarrasa, 08221 Tarrasa, Spain
18
Department of Surgery, Hospital Universitario Santa Creu i Sant Pau, 08025 Barcelona, Spain
19
Department of Surgery, Hospital Universitario de Badajoz, 06080 Badajoz, Spain
20
Department of Surgery, Hospital Universitario Doctor Peset, 46017 Valencia, Spain
21
Department of Surgery, Hospital Universitario de Basurto, 48013 Bilbao, Spain
22
Department of Surgery, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
23
Department of Surgery, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
24
Department of Surgery, Complejo Hospitalario Universitario de Vigo, 36312 Vigo, Spain
25
Department of Surgery, Hospital General Universitario de Albacete, 02008 Albacete, Spain
26
Department of Surgery, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
27
Department of Surgery, Hospital Universitario de A Coruña, 15006 A Coruña, Spain
28
Department of Surgery, Hospital Universitario Nuestra Señora de la Candelaria, 38010 Tenerife, Spain
29
Department of Surgery, Hospital Universitario Dr. Josep Trueta, 17007 Girona, Spain
30
Department of Surgery, Hospital Universitario Príncipe de Asturias, 28805 Alcalá de Henares, Spain
31
Department of Surgery, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
32
Department of Surgery, Hospital del Mar, 08003 Barcelona, Spain
33
Department of Surgery, Hospital Universitario de Getafe, 28905 Getafe, Spain
34
Department of Surgery, Hospital Universitario Arnau de Vilanova, 25198 Lleida, Spain
35
Department of Surgery, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
36
Department of Surgery, Hospital Universitario Morales Meseguer, 30008 Murcia, Spain
37
Department of Surgery, Hospital Universitario La Luz, 28003 Madrid, Spain
38
Department of Surgery, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain
39
Department of Surgery, Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain
40
Department of Surgery, Hospital General de Valencia, 46014 Valencia, Spain
41
Department of Surgery, Hospital Royo Villanova, 50015 Zaragoza, Spain
42
Department of Surgery, Hospital Clínico de San Carlos, 28040 Madrid, Spain
43
Department of Surgery, Hospital Universitario de Elche, 03203 Elche, Spain
44
Department of Surgery, Hospital Universitario Salamanca, 37007 Salamanca, Spain
45
Department of Surgery, Hospital Clínico de Valladolid, 47007 Valladolid, Spain
46
Instituto de Investigación Biosanitaria ibs.GRANADA, School of Medicine, University of Granada, 18016 Granada, Spain
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2025, 14(17), 6013; https://doi.org/10.3390/jcm14176013 (registering DOI)
Submission received: 23 July 2025 / Revised: 15 August 2025 / Accepted: 21 August 2025 / Published: 25 August 2025
(This article belongs to the Special Issue New Insights into Pancreatic Surgery)

Abstract

Background/Objectives: Like many other countries, the management of pancreatic cancer in Spain has developed in a fragmented manner. This study analyzes clinical outcomes related to patient volume at different centers after left pancreatectomy (LP). Our goal is to determine whether our practices align with the standards established in the literature and assess whether centralization’s advantages significantly outweigh its disadvantages. Methods: The SPANDISPAN Project (SPANish DIStal PANcreatectomy) is an observational, prospective, multicenter study focused on LP conducted in Spanish Hepato-Pancreato-Biliary (HPB) Surgery Units from 1 February 2022 to 31 January 2023. HPB units were defined as high volume if they performed more than 10 LPs annually. Results: This study included 313 patients who underwent LP at 42 centers across Spain over the course of a year. A total of 40.3% of the procedures were performed in high-volume centers. Significant differences in preoperative variables were only observed in ASA scores, which were higher in the high-volume group. Intraoperatively, minimally invasive surgical techniques were performed more frequently in high-volume centers. Postoperatively, the administration of somatostatin, major complications, and B and C postoperative pancreatic fistula (POPF) were more frequent in low-volume hospitals. Conclusions: The findings revealed that high-volume centers had a higher rate of minimally invasive surgery, lower intraoperative bleeding, fewer complications, and reduced POPFs compared to low-volume centers. However, it is important to note that low-volume centers still demonstrated acceptable outcomes. Thus, the selective referral of more complex laparoscopic procedures could initiate a gradual centralization of surgical practices.
Keywords: left pancreatectomy; volume; outcomes; surgery; regionalization left pancreatectomy; volume; outcomes; surgery; regionalization

Share and Cite

MDPI and ACS Style

Aparicio-López, D.; Ramia, J.M.; Villodre, C.; Rubio-García, J.J.; Hernández, B.; Busquets, J.; Secanella, L.; Peláez, N.; Alkorta, M.; de-Ariño-Hervás, I.; et al. Effect of Volume on Postoperative Outcomes After Left Pancreatectomy: A Multicenter Prospective Snapshot Study (SPANDISPAN Project). J. Clin. Med. 2025, 14, 6013. https://doi.org/10.3390/jcm14176013

AMA Style

Aparicio-López D, Ramia JM, Villodre C, Rubio-García JJ, Hernández B, Busquets J, Secanella L, Peláez N, Alkorta M, de-Ariño-Hervás I, et al. Effect of Volume on Postoperative Outcomes After Left Pancreatectomy: A Multicenter Prospective Snapshot Study (SPANDISPAN Project). Journal of Clinical Medicine. 2025; 14(17):6013. https://doi.org/10.3390/jcm14176013

Chicago/Turabian Style

Aparicio-López, Daniel, José M. Ramia, Celia Villodre, Juan J. Rubio-García, Belén Hernández, Juli Busquets, Luis Secanella, Nuria Peláez, Maialen Alkorta, Itziar de-Ariño-Hervás, and et al. 2025. "Effect of Volume on Postoperative Outcomes After Left Pancreatectomy: A Multicenter Prospective Snapshot Study (SPANDISPAN Project)" Journal of Clinical Medicine 14, no. 17: 6013. https://doi.org/10.3390/jcm14176013

APA Style

Aparicio-López, D., Ramia, J. M., Villodre, C., Rubio-García, J. J., Hernández, B., Busquets, J., Secanella, L., Peláez, N., Alkorta, M., de-Ariño-Hervás, I., Achalandabaso, M., Toledo-Martínez, E., Rotellar, F., Martí-Cruchaga, P., Gómez-Bravo, M. A., Suárez-Artacho, G., Garcés-Albir, M., Sabater, L., García-Plaza, G., ... Serradilla-Martín, M. (2025). Effect of Volume on Postoperative Outcomes After Left Pancreatectomy: A Multicenter Prospective Snapshot Study (SPANDISPAN Project). Journal of Clinical Medicine, 14(17), 6013. https://doi.org/10.3390/jcm14176013

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