Updates in surgery · 2026
Designing a national network of pancreas units: the Italian model for high-quality pancreatic cancer care.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Alfieri Sergio, Quero Giuseppe, Tondolo Vincenzo, Balzano Giampaolo, Cardone Antonella, Conzo Giovanni, Fabbri Carlo, Ferrari Viviana, Frulloni Luca, Gruttadauria Salvatore, Ianelli Elisabetta, Maiello Evaristo, Menghi Roberta, Milella Michele, Reni Michele, Salvia Roberto, Spada Cristiano, De Bella Manuela Tamburo, Tarantino Ilaria, Tortora Giampaolo, Valsecchi Federica, Vincenti Leonardo, Vistoli Fabio, Boggi Ugo
Аннотация
Pancreatic and periampullary cancers are among the most challenging malignancies. Centralization of care and multidisciplinary management have been associated with improved outcomes. In 2024,the Italian Ministry of Health established a national Steering Committee with the objective of defining a centralized model for the management of pancreatic and periampullary diseases and identifying the minimum requirements for referral centers across Italy. The Steering Committee met every four weeks through plenary and focused working groups. Using data from the National Agency for Regional Health Services and the National Outcome Program, all ICD-9 codes related to pancreatic, periampullary, and distal biliary diseases were analyzed. Criteria were developed according to international recommendations and structured into a Hub-and-Spoke network model. Pancreas Units(Hub centers) were defined as hospitals providing 24/7 multidisciplinary expertise, advanced diagnostic and interventional capabilities, and a minimum surgical volume of ≥ 30 pancreatic resections per year with 90-day mortality < 10% (target < 5% within 3 years). Spoke centers were required to adhere to standardized diagnostic–therapeutic pathways and participate in multidisciplinary team meetings, without performing pancreatic surgery. Based on catchment area analyses, one Hub center per 700,000–1,200,000 inhabitants was recommended. Additional requirements included structured multidisciplinary processes, standardized diagnostic pathways, and integration with national research and training networks. This national model provides a comprehensive framework for centralizing pancreatic and periampullary diseases care. By defining minimum standards, enhancing multidisciplinary coordination, and concentrating complex procedures in high-performance centers, this initiative aims to improve outcomes, reduce regional disparities, and create a sustainable national Pancreas Unit network.