Zoe McCormack, Aisling Kerr, Andrew Simpson, Dolores Keating, Judith Strawbridge
What works for whom, how and why in mental health education for undergraduate health profession students? A realist synthesis protocol
BMJ open
historically pancreaticoduodenectomy pd performed via laparotomy increasingly laparoscopic robotic platforms employed pd laparoscopic pd steep surgeon specific learning curve programmatic elements must optimized factors may limit surgeon proficient laparoscopic pd develop program another institution hypothesize learning curve surgeon transferring program second institution shorter initial laparoscopic pd learning curve surgeon retrospective review patients underwent laparoscopic pd indication first institution fi 2012 2017 second institution si 2018 2021 conducted standard statistical analysis performed learning curve identified using onesided cusum analysis operative times identified 110 participants 90 fi 20 si patients fi diagnosed periampullary adenocarcinoma final pathology compared si 656 vs 400 p 0132 fi operative times stabilized 25th laparoscopic pd si operative times stabilized 5th operation statistically significant difference identified postoperative complications learning curve average operative time si laparoscopic pd program shorter initial learning curve single surgeon comparable outcomes suggests complex minimally invasive surgical programs safely transferred another highvolume institution without significant loss progress