Background:
A number of studies have highlighted significantly better outcomes of complex surgical procedures like pancreaticoduodenectomies (PD) performed at high volume centres. Volume of surgery has become a surrogate marker of quality. Consequently a lot of emphasis is being placed on regionalising these complex surgeries.

Aim:
The aim of this study was to analyse the perioperative outcomes of PD at a low volume tertiary centre.

Methods:
A retrospective analysis of all PD from 1998 to 2012 was performed. Perioperative outcomes including morbidity and 90 day mortality as well as long-term survival and recurrence were assessed.
Results:
A total of 53 patients underwent PD during this period. Overall perioperative mortality was 3.8%. Last perioperative mortality occurred in 1999. Median survival was 16 months (1 – 105) in the entire study population. Overall perioperative morbidity was 37.7%.

Conclusion:
PD can be safely performed at a low volume tertiary centre. National Surgical quality improvement programme (NSQIP) risk calculator can provide a useful guideline in selecting patients for PD.