Do patients outcomes suffer when surgical fellows are involved in hepatic resection?

Neil H. Bhayani, Osama H. Hamed, Aditya Gupta, Gail Ortenzi, Jussuf T. Kaifi, Eric T. Kimchi, Kevin F. Staveley-O'Carroll, Niraj J. Gusani

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Introduction Hepatectomy is an advanced technique learned during surgical fellowship. Outcomes have not been described for hepatectomies involving fellows. Methods We analyzed hepatectomies from the 2005-2011 National Surgical Quality Improvement Program database. We compared cases with a fellow (FELLOW group) and those without a fellow (ATTENDING group). Results FELLOW cases (n = 1,562; 54%) included more major hepatectomies and more metastasectomies (P <.002). Mortality was 3.2% versus 2.7% (P =.5) and morbidity was 30.7% vs 26.2% (P =.008) for FELLOW versus ATTENDING cases. On multivariate analysis, mortality was similar, but morbidity was greater in FELLOW cases (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.02-1.4; P =.03), with increased superficial surgical site infections (OR, 1.72; 95% CI, 1.2-2.4; P =.001). There were no differences in rates of sepsis, cardiac, pulmonary, or thromboembolic complications. Compared with ATTENDING cases, FELLOW cases during the first half of training, carried greater morbidity (OR, 1.43; 95% CI, 1.1-1.8; P =.006); however, this difference disappears by the second half of the academic year. Conclusion Hepatectomy involving a fellow may be associated with an increased risk of surgical site infections. FELLOW cases were more complex. Mortality, cardiac, pulmonary, and other serious morbidities were similar. Despite slightly greater rates of surgical site infections, training in hepatic surgery maintains excellent patient outcomes.

Original languageEnglish (US)
Pages (from-to)1024-1030
Number of pages7
JournalSurgery (United States)
Issue number5
StatePublished - Nov 2013

All Science Journal Classification (ASJC) codes

  • Surgery


Dive into the research topics of 'Do patients outcomes suffer when surgical fellows are involved in hepatic resection?'. Together they form a unique fingerprint.

Cite this