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Article Dans Une Revue British Journal of Surgery Année : 2022

Benchmarking of minimally invasive distal pancreatectomy with splenectomy: European multicentre study

Alessandro Giani
Michele Mazzola
Mushegh Sahakyan
Ugo Boggi
Claudio Ricci
Safi Dokmak
Giovanni Butturini
  • Fonction : Auteur
Isabella Frigerio
  • Fonction : Auteur
Bergthor Björnsson
Fernando Burdio
  • Fonction : Auteur
Mathieu d'Hondt
  • Fonction : Auteur
Andrea Coratti
  • Fonction : Auteur
Bilal Al-Sarireh
  • Fonction : Auteur
Marco Marino
Giovanni Ferrari
  • Fonction : Auteur

Résumé

Background: Benchmarking is the process to used assess the best achievable results and compare outcomes with that standard. This study aimed to assess best achievable outcomes in minimally invasive distal pancreatectomy with splenectomy (MIDPS). Methods: This retrospective study included consecutive patients undergoing MIDPS for any indication, between 2003 and 2019, in 31 European centres. Benchmarks of the main clinical outcomes were calculated according to the Achievable Benchmark of Care (ABC™) method. After identifying independent risk factors for severe morbidity and conversion, risk-adjusted ABCs were calculated for each subgroup of patients at risk. Results: A total of 1595 patients were included. The ABC was 2.5 per cent for conversion and 8.4 per cent for severe morbidity. ABC values were 160 min for duration of operation time, 8.3 per cent for POPF, 1.8 per cent for reoperation, and 0 per cent for mortality. Multivariable analysis showed that conversion was associated with male sex (OR 1.48), BMI exceeding 30 kg/m2 (OR 2.42), multivisceral resection (OR 3.04), and laparoscopy (OR 2.24). Increased risk of severe morbidity was associated with ASA fitness grade above II (OR 1.60), multivisceral resection (OR 1.88), and robotic approach (OR 1.87). Conclusion: The benchmark values obtained using the ABC method represent optimal outcomes from best achievable care, including low complication rates and zero mortality. These benchmarks should be used to set standards to improve patient outcomes.
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Dates et versions

hal-04167647 , version 1 (13-02-2024)

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Alessandro Giani, Tess van Ramshorst, Michele Mazzola, Claudio Bassi, Alessandro Esposito, et al.. Benchmarking of minimally invasive distal pancreatectomy with splenectomy: European multicentre study. British Journal of Surgery, 2022, 109 (11), pp.1124-1130. ⟨10.1093/bjs/znac204⟩. ⟨hal-04167647⟩
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