System for the safe deployment of minimally invasive pancreaticobiliary surgery in Japan

Abstract

The Japanese healthcare system is characterized by universal coverage and free access. It is an excellent social system that allows everyone to receive advanced medical care at a low cost. Minimally invasive hepato-pancreato-biliary (HPB) surgery in Japan is now covered by insurance. However, after experiencing a series of serious medical accidents, Japan’s government requested a more advanced system to safely promote highly advanced surgery including laparoscopic HBP surgery. As a practical measure, the academic societies of HPB surgery established a new prospective registration system for all cases of minimally invasive HPB for highly advanced hepatobiliary and pancreatic surgery while utilizing the existing technical certification system. Under these systems, hepatobiliary and pancreatic surgeries in Japan are now being undertaken gradually but safely.

Keywords

Minimally invasive surgery / hepatectomy / pancreatectomy

References

[1] Skirbekk V,Stonawski M.The health-adjusted dependency ratio as a new global measure of the burden of ageing: a population-based study.Lancet Healthy Longev2022;3:e332-8

[2] Mueller M,Mizuno T.Perihilar cholangiocarcinoma - novel benchmark values for surgical and oncological outcomes from 24 expert centers.Ann Surg2021;274:780-8

[3] Yamakawa T,Sakai S.Preliminary experience using an ultrasonic aspirator for laparoscopic cholecystectomy.Endoscopy1992;24:721-3

[4] Kaneko H,Shiba T.Laparoscopic partial hepatectomy and left lateral segmentectomy: technique and results of a clinical series.Surgery1996;120:468-75

[5] Miura F,Gotoh M.Validation of the board certification system for expert surgeons (hepato-biliary-pancreatic field) using the data of the National Clinical Database of Japan: part 1 - hepatectomy of more than one segment.J Hepatobiliary Pancreat Sci2016;23:313-23

[6] Marubashi S,Kakeji Y.Surgical outcomes in gastroenterological surgery in Japan: report of the National Clinical Database 2011-2019.Ann Gastroenterol Surg2021;5:639-58 PMCID:PMC8452469

[7] Ban D,Kumamaru H.Safe dissemination of laparoscopic liver resection in 27,146 cases between 2011 and 2017 from the National Clinical Database of Japan.Ann Surg2021;274:1043-50

[8] Goh BKP,Chen KH.Defining global benchmarks for laparoscopic liver resections: an international multicenter study.Ann Surg2022:10.1097

[9] Ohtsuka T,Toyama H.A multicenter prospective registration study on laparoscopic pancreatectomy in Japan: report on the assessment of 1,429 patients.J Hepatobiliary Pancreat Sci2020;27:47-55

[10] Nakata K,Miyata H.Comparison of outcomes between laparoscopic and open pancreaticoduodenectomy without radical lymphadenectomy: results of coarsened exact matching analysis using national database systems.Asian J Endosc Surg2022;15:15-21

[11] Ban D,Ito H.A novel difficulty scoring system for laparoscopic liver resection.J Hepatobiliary Pancreat Sci2014;21:745-53

[12] Ohtsuka T,Nakamura Y.Difficulty scoring system in laparoscopic distal pancreatectomy.J Hepatobiliary Pancreat Sci2018;25:489-97