Definitions
Pancreatic ductal adenocarcinoma, bile duct cancer, duodenal and ampullary adenocarcinomas, intraductal papillary mucinous neoplasms (IPMNs), and pancreatic neuroendocrine tumors (pNETs) were defined in accordance to the WHO definitions.8,9 A hospital was defined as a high-volume pancreatic center when performing ≥20 pancreatoduodenectomies annually.10 Consensus was defined as >80% agreement among respondents and moderate agreement was defined as 60% to 80% agreement among them.