Letter to Editor Reply to: “Centralization of Pancreatic Surgery in Europe: an Update”
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We thank the authors from Norway for their important comments and update to our systematic review of centralization of pancreatic surgery in Europe.
We are aware of the fact that many countries in Europe try to establish special referral centers for pancreatic surgery. However, even though many European countries try to centralize pancreatic surgery, strategies, data on efficacy, and outcomes are often not published yet. A review confounds on the available data and is always a snapshot of the current situation. Indeed, the study references from Norway were not published at the time of our literature search, which ended in December 2017.1
The volume-outcome association might be a matter of debate, but at present, centralization is one of the most established and particularly modifiable tool to ensure the optimal outcome for patients requiring pancreatic surgery. The recently published nationwide audit data from the Netherlands again shows differences regarding the mortality between...