Table I.
Mean and total number of cases performed during the Chief (PGY-5) and Junior (PGY 1-4) years of residency in each category of complex hepatopancreatobiliary surgery
| 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | Total | Overall mean | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mean | ||||||||||||
| Liver (Chief) | 4.4 | 4.2 | 4.3 | 4.4 | 4.5 | 4.5 | 4.7 | 4.6 | 4.6 | 4.5 | 44.7 | 4.5 |
| Anatomic | 2.4 | 2.5 | 2.5 | 2.5 | 2.7 | 2.8 | 3.0 | 2.9 | 2.8 | 2.8 | 26.9 | 2.7 |
| Wedge | 1.4 | 1.3 | 1.3 | 1.4 | 1.3 | 1.2 | 1.2 | 1.1 | 1.0 | 0.9 | 12.1 | 1.2 |
| Other | 0.6 | 0.4 | 0.5 | 0.5 | 0.5 | 0.5 | 0.5 | 0.6 | 0.8 | 0.8 | 5.7 | 0.6 |
| Liver (Junior) | 3.7 | 4.0 | 3.7 | 4.0 | 4.2 | 4.4 | 4.7 | 4.6 | 5.0 | 5.0 | 43.3 | 4.3 |
| Anatomic | 1.3 | 1.5 | 1.4 | 1.6 | 1.8 | 1.9 | 2.2 | 2.2 | 2.3 | 2.4 | 18.6 | 1.9 |
| Wedge | 1.8 | 1.9 | 1.7 | 1.8 | 1.7 | 1.8 | 1.8 | 1.6 | 1.7 | 1.4 | 17.2 | 1.7 |
| Other | 0.6 | 0.6 | 0.6 | 0.6 | 0.7 | 0.7 | 0.7 | 0.8 | 1.0 | 1.2 | 7.5 | 0.8 |
| Pancreas (Chief) | 6.3 | 6.5 | 6.5 | 6.6 | 7.0 | 7.3 | 7.6 | 7.4 | 7.5 | 7.2 | 69.9 | 7.0 |
| Pancreatoduodenectomy | 2.9 | 3.1 | 3.2 | 3.4 | 3.6 | 3.8 | 4.0 | 3.6 | 3.7 | 3.7 | 35.0 | 3.5 |
| Distal | 1.4 | 1.4 | 1.6 | 1.7 | 1.8 | 2.0 | 2.1 | 2.1 | 2.0 | 2.0 | 18.1 | 1.8 |
| Other | 2.0 | 2.0 | 1.7 | 1.5 | 1.8 | 1.5 | 1.5 | 1.7 | 1.8 | 1.5 | 17.0 | 1.7 |
| Pancreas (Junior) | 2.9 | 3.2 | 3.1 | 3.6 | 3.6 | 3.5 | 4.0 | 4.2 | 4.2 | 4.2 | 36.5 | 3.7 |
| Pancreatoduodenectomy | 0.9 | 1.1 | 1.0 | 1.4 | 1.4 | 1.4 | 1.6 | 1.6 | 1.6 | 1.6 | 13.6 | 1.4 |
| Distal | 0.6 | 0.7 | 0.7 | 0.9 | 0.9 | 0.9 | 1.1 | 1.1 | 1.2 | 1.2 | 9.3 | 0.9 |
| Other | 1.4 | 1.4 | 1.4 | 1.3 | 1.3 | 1.2 | 1.3 | 1.5 | 1.4 | 1.4 | 13.6 | 1.4 |
| Biliary (Chief) | 2.8 | 2.7 | 2.8 | 2.6 | 2.5 | 2.4 | 2.4 | 2.2 | 2.1 | 2.0 | 24.5 | 2.5 |
| CBDE | 1.1 | 1.1 | 0.9 | 0.9 | 0.9 | 0.9 | 0.9 | 0.8 | 0.8 | 0.7 | 9.0 | 0.9 |
| CDE | 1.6 | 1.5 | 1.6 | 1.4 | 1.3 | 1.2 | 1.2 | 1.1 | 1.0 | 1.0 | 12.9 | 1.3 |
| Other | 0.1 | 0.1 | 0.3 | 0.3 | 0.3 | 0.3 | 0.3 | 0.3 | 0.3 | 0.3 | 2.6 | 0.3 |
| Biliary (Junior) | 3.1 | 3.1 | 2.8 | 2.7 | 2.6 | 2.5 | 2.7 | 2.5 | 2.5 | 2.4 | 26.9 | 2.7 |
| CBDE | 1.9 | 1.8 | 1.5 | 1.4 | 1.3 | 1.2 | 1.3 | 1.2 | 1.2 | 1.2 | 14.0 | 1.4 |
| CDE | 1.1 | 1.1 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 0.9 | 0.9 | 0.9 | 9.9 | 1.0 |
| Other | 0.1 | 0.2 | 0.3 | 0.3 | 0.3 | 0.3 | 0.4 | 0.4 | 0.4 | 0.3 | 3.0 | 0.3 |
| Subtotal | 23.2 | 23.7 | 23.2 | 23.9 | 24.4 | 24.6 | 26.1 | 25.5 | 25.9 | 25.3 | 245.8 | 24.6 |
| Total | ||||||||||||
| Liver (Chief) | 4,915 | 4,876 | 4,947 | 4,889 | 4,660 | 4,571 | 4,473 | 4,354 | 4,387 | 4,248 | 46,320 | 4,632 |
| Anatomic | 3,058 | 2,968 | 3,033 | 3,104 | 2,847 | 2,741 | 2,570 | 2,529 | 2,573 | 2,387 | 27,810 | 2,781 |
| Wedge | 983 | 1,060 | 1,190 | 1,286 | 1,272 | 1,323 | 1,374 | 1,345 | 1,364 | 1,338 | 12,535 | 1,254 |
| Other | 874 | 848 | 724 | 499 | 5,41 | 507 | 529 | 480 | 450 | 523 | 5,975 | 598 |
| Liver (Junior) | 5,460 | 5,300 | 4,818 | 4,861 | 4,484 | 4,265 | 4,150 | 3,854 | 4,060 | 3,573 | 44,825 | 4,483 |
| Anatomic | 2,621 | 2,438 | 2,320 | 2,298 | 1,940 | 1,804 | 1,660 | 1,443 | 1,557 | 1,241 | 19,322 | 1,932 |
| Wedge | 1,529 | 1,802 | 1,690 | 1,841 | 1,844 | 1,755 | 1,849 | 1,784 | 1,910 | 1,775 | 17,779 | 1,778 |
| Other | 1,310 | 1,060 | 808 | 722 | 700 | 706 | 641 | 627 | 593 | 557 | 7,724 | 772 |
| Pancreas (Chief) | 7,862 | 7,950 | 7,737 | 7,963 | 7,339 | 7,028 | 6,741 | 6,652 | 6,651 | 6,089 | 72,012 | 7,201 |
| Pancreatoduodenectomy | 4,040 | 3,922 | 3,776 | 4,149 | 3,826 | 3,627 | 3,409 | 3,286 | 3,122 | 2,836 | 35,993 | 3,599 |
| Distal | 2,184 | 2,120 | 2,156 | 2,163 | 1,989 | 1,761 | 1,732 | 1,619 | 1,466 | 1,335 | 18,525 | 1,853 |
| Other | 1,638 | 1,908 | 1,805 | 1,651 | 1,524 | 1,640 | 1,600 | 1,747 | 2,063 | 1,918 | 17,494 | 1,749 |
| Pancreas (Junior) | 4,586 | 4,452 | 4,269 | 4,185 | 3,656 | 3,523 | 3,495 | 3,178 | 3,289 | 2,832 | 37,465 | 3,747 |
| Pancreatoduodenectomy | 1,747 | 1,696 | 1,680 | 1,690 | 1,467 | 1,361 | 1,361 | 1,045 | 1,103 | 837 | 13,987 | 1,399 |
| Distal | 1,310 | 1,272 | 1,113 | 1,113 | 957 | 923 | 857 | 738 | 732 | 604 | 9,619 | 962 |
| Other | 1,529 | 1,484 | 1,476 | 1,382 | 1,232 | 1,239 | 1,277 | 1,395 | 1,454 | 1,391 | 13,859 | 1,386 |
| Biliary (Chief) | 2,184 | 2,226 | 2,272 | 2,425 | 2,439 | 2,467 | 2,613 | 2,873 | 2,843 | 2,842 | 25,184 | 2,518 |
| CBDE | 764 | 848 | 783 | 901 | 933 | 887 | 897 | 958 | 1,095 | 1,110 | 9,176 | 918 |
| CDE | 1,092 | 1,060 | 1,188 | 1,242 | 1,228 | 1,302 | 1,393 | 1,593 | 1,569 | 1,591 | 13,258 | 1,326 |
| Other | 328 | 318 | 301 | 282 | 278 | 278 | 323 | 322 | 179 | 141 | 2,750 | 275 |
| Biliary (Junior) | 2,621 | 2,650 | 2,532 | 2,754 | 2,511 | 2,575 | 2,781 | 2,817 | 2,996 | 2,934 | 27,171 | 2,717 |
| CBDE | 1,310 | 1,272 | 1,259 | 1,361 | 1,249 | 1,303 | 1,418 | 1,481 | 1,781 | 1,789 | 14,223 | 1,422 |
| CDE | 983 | 954 | 940 | 1,054 | 974 | 993 | 1,020 | 1,047 | 1,093 | 1,046 | 10,104 | 1,010 |
| Other | 328 | 424 | 333 | 339 | 288 | 279 | 343 | 289 | 122 | 99 | 2,844 | 284 |
| Subtotal | 27,628 | 27,454 | 26,575 | 27,077 | 25,089 | 24,429 | 24,253 | 23,728 | 24,226 | 22,518 | 25,2977 | 25,298 |
Anatomic, Lobectomy or segmentectomy; CBDE, common bile duct exploration; CDE, choledochoenterostomy; Chief, case volume performed during the fifth year of surgical residency; Junior, case volume performed over years 1–4; Other, other major.