Volume–outcome relationships in pancreatic surgery are well established with shorter hospital stay and lower mortality in high-volume centers.10,19,20 Pancreatic surgery in high-risk patients should not be performed in low-volume centers during the COVID-19 pandemic, aiming to reduce the risk of long hospital stay and major complications requiring ICU care (statement 16). Remarkably, the sensitivity analysis revealed that only Europe reached consensus in contrast to Asia and the Americas.