Background/Objectives: Like many other countries, the management of pancreatic cancer in Spain has developed in a fragmented manner. This study analyzes clinical outcomes related to patient volume at different centers after left pancreatectomy (LP). Our goal is to determine whether our practices align with the standards established in the literature and assess whether centralization’s advantages significantly outweigh its disadvantages. Methods: The SPANDISPAN Project (SPANish DIStal PANcreatectomy) is an observational, prospective, multicenter study focused on LP conducted in Spanish Hepato-Pancreato-Biliary (HPB) Surgery Units from 1 February 2022 to 31 January 2023. HPB units were defined as high volume if they performed more than 10 LPs annually. Results: This study included 313 patients who underwent LP at 42 centers across Spain over the course of a year. A total of 40.3% of the procedures were performed in high-volume centers. Significant differences in preoperative variables were only observed in ASA scores, which were higher in the high-volume group. Intraoperatively, minimally invasive surgical techniques were performed more frequently in high-volume centers. Postoperatively, the administration of somatostatin, major complications, and B and C postoperative pancreatic fistula (POPF) were more frequent in low-volume hospitals. Conclusions: The findings revealed that high-volume centers had a higher rate of minimally invasive surgery, lower intraoperative bleeding, fewer complications, and reduced POPFs compared to low-volume centers. However, it is important to note that low-volume centers still demonstrated acceptable outcomes. Thus, the selective referral of more complex laparoscopic procedures could initiate a gradual centralization of surgical practices.

Objetivo: Describir un caso de mucosa gástrica ectópica rectal (MEGR) diagnosticado en nuestro centro y realizar una revisión sistemática de la literatura publicada entre 2005-2025, identificar las características clínicas, diagnóstico, tratamiento y evolución de esta entidad.Caso clínico: Varón de 64 años a quien, durante una colonoscopia de control, se detectó una lesión rectal plana de 15 mm, resecada endoscópicamente sin complicaciones. El estudio histológico confirmó mucosa gástrica ectópica rectal sin displasia, sin recidiva ni síntomas en el seguimiento.Discusión: Se revisaron siete publicaciones que incluían diez casos de MEGR, con una edad media de 42 años y predominio masculino. La mayoría (70%) fueron sintomáticos, destacando rectorragia y dolor anal, mientras que en el 30% el diagnóstico fue incidental. Las lesiones se localizaron principalmente en el recto distal o medio, presentándose como formaciones polipoides (60%) o áreas planas ulceradas (20%). El tratamiento consistió en resección mucosa endoscópica en el 70% de los casos, con dos tratados quirúrgicamente y uno con manejo conservador. No se reportaron complicaciones ni displasia o malignidad. Conclusiones: La MEGR es una entidad rara pero relevante a considerar ante hallazgos rectales atípicos. La revisión sistemática permite identificar características comunes y estrategias diagnósticas y terapéuticas. La descripción de un nuevo caso contribuye a enriquecer el conocimiento actual.

Background/Objectives: Like many other countries, the management of pancreatic cancer in Spain has developed in a fragmented manner. This study analyzes clinical outcomes related to patient volume at different centers after left pancreatectomy (LP). Our goal is to determine whether our practices align with the standards established in the literature and assess whether centralization's advantages significantly outweigh its disadvantages. Methods: The SPANDISPAN Project (SPANish DIStal PANcreatectomy) is an observational, prospective, multicenter study focused on LP conducted in Spanish Hepato-Pancreato-Biliary (HPB) Surgery Units from February 1st, 2022, to January 31st, 2023. HPB units were defined as high volume if they performed more than 10 LPs annually. Results: This study included 313 patients who underwent LP at 41 centers across Spain over the course of a year. 40.3% of the procedures were performed in high-volume centers. Significant differences in preoperative variables were only ob-served in ASA scores, which were higher in the high-volume group. Intraoperatively, minimally invasive surgical techniques were performed more frequently in high-volume centers. Postoperatively, the administration of somatostatin, major com-plications, and B and C postoperative pancreatic fistula (POPF) were more frequent in low-volume hospitals. Conclusions: The findings revealed that high-volume centers had a higher rate of minimally invasive surgery, lower intraoperative bleeding, fewer complications, and reduced POPFs compared to low-volume centers. However, it is important to note that low-volume centers still demonstrated acceptable outcomes. Thus, the selective referral of more complex laparoscopic procedures could initiate a gradual centralization of surgical practices.