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1. Use and outcome of minimally invasive pancreatic surgery in the European E-MIPS registry

Author

Vilhav, Caroline, Hartman, Vera, Kirkegård, Jakob, Sergeant, Gregory, Kleeff, Jörg, Coolsen, Marielle, Coppola, Roberto, Pauletti, Bruno, Mittermair, Christof, Tingstedt, Bobby, Erkan, Mert, Tomazic, Ales, Korkolis, Dimitris, van der Heijde, Nicky, Vissers, Frederique L., Manzoni, Alberto, Zimmitti, Giuseppe, Balsells, Joaquim, Berrevoet, Frederik, Bjornsson, Bergthor, van den Boezem, Peter, Boggi, Ugo, Bratlie, Svein O., Burdio, Fernando, Coratti, Andrea, D'Hondt, Mathieu, Del Pozo, Carlos D., Dokmak, Safi, Fara, Regis, Can, Mehmet F., Festen, Sebastiaan, Forgione, Antonello, Fristrup, Claus, Gaujoux, Sebastien, Groot Koerkamp, Bas, Hackert, Thilo, Khatkov, Igor E., Keck, Tobias, Seppänen, Hanna, Lips, Daan, Luyer, Misha, Pittau, Gabriella, Maglione, Manuel, Molenaar, I. Quintus, Pessaux, Patrick, Roeyen, Geert, Saint-Marc, Olivier, Cabus, Santiago S., van Santvoort, Hjalmar, van der Schelling, George, Serradilla-Martin, Mario, Souche, Francois-regis, Suarez Muñoz, Miguel Á., Marino, Marco V., Besselink, Marc G., and Abu Hilal, Mohammed

Published
2023
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2. Standardizing definitions and terminology of left-sided pancreatic resections through an international Delphi consensus

Author

MS CGO, Cancer, van Ramshorst, Tess M.E., van Hilst, Jony, Boggi, Ugo, Dokmak, Safi, Edwin, Bjørn, Keck, Tobias, Khatkov, Igor, Balduzzi, Alberto, Pulvirenti, Alessandra, Ahmad, Jawad, Saati, Hani Al, Alseidi, Adnan, Ausania, Fabio, Azagra, Juan S., Balzano, Gianpaolo, Björnsson, Bergthor, Can, Fatih M., Cillo, Umberto, D’Hondt, Mathieu, Efanov, Mikhail, Erkan, Mert, Alvarez, Francisco Espin, Esposito, Alessandro, Ferrari, Giovanni, Koerkamp, Bas Groot, Gumbs, Andrew A., Hogg, Melissa E., Ielpo, Benedetto, Ivanecz, Arpad, Jang, Jin Young, Kleive, Dyre, Kooby, David A., Luyer, Misha D.P., Marchegiani, Giovanni, Menon, Krishna, Molenaar, I. Quintus, Nagakawa, Yuichi, Nakamura, Masafumi, Palumbo, Diego, Piardi, Tullio, Ramia, Jose M., Saint-Marc, Olivier, Salti, George I., Strobel, Oliver, Vollmer, Charles M., Wei, Alice C., White, Steve, Yoon, Yoo Seok, Zerbi, Alessandro, Bassi, Claudio, Berrevoet, Frederik, Chan, Carlos, Coimbra, Felipe J., Conlon, Kevin C.P., Dervenis, Christos, Falconi, Massimo, Frigerio, Isabella, Fusai, Giuseppe K., De Oliveira, Michelle L., Pinna, Antonio D., Primrose, John N., Sauvanet, Alain, Serrablo, Alejandro, Smadi, Sameer, Alfieri, Sergio, Berti, Stefano, Butturini, Giovanni, Casadei, Riccardo, Coppola, Roberto, Benedetto, Fabrizio Di, Ettorre, Giuseppe M., Giuliante, Felice, Jovine, Elio, Memeo, Riccardo, Pietrabissa, Andrea, Portolani, Nazario, Salvia, Roberto, Siriwardena, Ajith K., Asbun, Horacio J., Besselink, Marc G., Hilal, Mohammad Abu, MS CGO, Cancer, van Ramshorst, Tess M.E., van Hilst, Jony, Boggi, Ugo, Dokmak, Safi, Edwin, Bjørn, Keck, Tobias, Khatkov, Igor, Balduzzi, Alberto, Pulvirenti, Alessandra, Ahmad, Jawad, Saati, Hani Al, Alseidi, Adnan, Ausania, Fabio, Azagra, Juan S., Balzano, Gianpaolo, Björnsson, Bergthor, Can, Fatih M., Cillo, Umberto, D’Hondt, Mathieu, Efanov, Mikhail, Erkan, Mert, Alvarez, Francisco Espin, Esposito, Alessandro, Ferrari, Giovanni, Koerkamp, Bas Groot, Gumbs, Andrew A., Hogg, Melissa E., Ielpo, Benedetto, Ivanecz, Arpad, Jang, Jin Young, Kleive, Dyre, Kooby, David A., Luyer, Misha D.P., Marchegiani, Giovanni, Menon, Krishna, Molenaar, I. Quintus, Nagakawa, Yuichi, Nakamura, Masafumi, Palumbo, Diego, Piardi, Tullio, Ramia, Jose M., Saint-Marc, Olivier, Salti, George I., Strobel, Oliver, Vollmer, Charles M., Wei, Alice C., White, Steve, Yoon, Yoo Seok, Zerbi, Alessandro, Bassi, Claudio, Berrevoet, Frederik, Chan, Carlos, Coimbra, Felipe J., Conlon, Kevin C.P., Dervenis, Christos, Falconi, Massimo, Frigerio, Isabella, Fusai, Giuseppe K., De Oliveira, Michelle L., Pinna, Antonio D., Primrose, John N., Sauvanet, Alain, Serrablo, Alejandro, Smadi, Sameer, Alfieri, Sergio, Berti, Stefano, Butturini, Giovanni, Casadei, Riccardo, Coppola, Roberto, Benedetto, Fabrizio Di, Ettorre, Giuseppe M., Giuliante, Felice, Jovine, Elio, Memeo, Riccardo, Pietrabissa, Andrea, Portolani, Nazario, Salvia, Roberto, Siriwardena, Ajith K., Asbun, Horacio J., Besselink, Marc G., and Hilal, Mohammad Abu

Published
2024

3. The Brescia Internationally Validated European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS)

Author

Abu Hilal, Mohammad, Van Ramshorst, Tess M.E., Boggi, Ugo, Dokmak, Safi, Edwin, Bjørn, Keck, Tobias, Khatkov, Igor, Ahmad, Jawad, Al Saati, Hani, Alseidi, Adnan, Azagra, Juan S., Björnsson, Bergthor, Can, Fatih M., D'Hondt, Mathieu, Efanov, Mikhail, Espin Alvarez, Francisco, Esposito, Alessandro, Ferrari, Giovanni, Groot Koerkamp, Bas, Gumbs, Andrew A., Hogg, Melissa E., Huscher, Cristiano G.S., Ielpo, Benedetto, Ivanecz, Arpad, Jang, Jin Young, Liu, Rong, Luyer, Misha D.P., Menon, Krishna, Nakamura, Masafumi, Piardi, Tullio, Saint-Marc, Olivier, White, Steve, Yoon, Yoo Seok, Zerbi, Alessandro, Bassi, Claudio, Berrevoet, Frederik, Chan, Carlos, Coimbra, Felipe J., Conlon, Kevin C.P., Cook, Andrew, Dervenis, Christos, Falconi, Massimo, Ferrari, Clarissa, Frigerio, Isabella, Fusai, Giuseppe K., De Oliveira, Michelle L., Pinna, Antonio D., Primrose, John N., Sauvanet, Alain, Serrablo, Alejandro, Smadi, Sameer, Badran, Ali, Baychorov, Magomet, Bannone, Elisa, Van Bodegraven, Eduard A., Emmen, Anouk M.L.H., Giani, Alessandro, De Graaf, Nine, Van Hilst, Jony, Jones, Leia R., Levi Sandri, Giovanni B., Pulvirenti, Alessandra, Ramera, Marco, Rashidian, Niki, Sahakyan, Mushegh A., Uijterwijk, Bas A., Zampedri, Pietro, Zwart, Maurice J.W., Alfieri, Sergio, Berti, Stefano, Butturini, Giovanni, Di Benedetto, Fabrizio, Ettorre, Giuseppe M., Giuliante, Felice, Jovine, Elio, Memeo, Riccardo, Portolani, Nazario, Ruzzenente, Andrea, Salvia, Roberto, Siriwardena, Ajith K., Besselink, Marc G., Asbun, Horacio J., Abu Hilal, Mohammad, Van Ramshorst, Tess M.E., Boggi, Ugo, Dokmak, Safi, Edwin, Bjørn, Keck, Tobias, Khatkov, Igor, Ahmad, Jawad, Al Saati, Hani, Alseidi, Adnan, Azagra, Juan S., Björnsson, Bergthor, Can, Fatih M., D'Hondt, Mathieu, Efanov, Mikhail, Espin Alvarez, Francisco, Esposito, Alessandro, Ferrari, Giovanni, Groot Koerkamp, Bas, Gumbs, Andrew A., Hogg, Melissa E., Huscher, Cristiano G.S., Ielpo, Benedetto, Ivanecz, Arpad, Jang, Jin Young, Liu, Rong, Luyer, Misha D.P., Menon, Krishna, Nakamura, Masafumi, Piardi, Tullio, Saint-Marc, Olivier, White, Steve, Yoon, Yoo Seok, Zerbi, Alessandro, Bassi, Claudio, Berrevoet, Frederik, Chan, Carlos, Coimbra, Felipe J., Conlon, Kevin C.P., Cook, Andrew, Dervenis, Christos, Falconi, Massimo, Ferrari, Clarissa, Frigerio, Isabella, Fusai, Giuseppe K., De Oliveira, Michelle L., Pinna, Antonio D., Primrose, John N., Sauvanet, Alain, Serrablo, Alejandro, Smadi, Sameer, Badran, Ali, Baychorov, Magomet, Bannone, Elisa, Van Bodegraven, Eduard A., Emmen, Anouk M.L.H., Giani, Alessandro, De Graaf, Nine, Van Hilst, Jony, Jones, Leia R., Levi Sandri, Giovanni B., Pulvirenti, Alessandra, Ramera, Marco, Rashidian, Niki, Sahakyan, Mushegh A., Uijterwijk, Bas A., Zampedri, Pietro, Zwart, Maurice J.W., Alfieri, Sergio, Berti, Stefano, Butturini, Giovanni, Di Benedetto, Fabrizio, Ettorre, Giuseppe M., Giuliante, Felice, Jovine, Elio, Memeo, Riccardo, Portolani, Nazario, Ruzzenente, Andrea, Salvia, Roberto, Siriwardena, Ajith K., Besselink, Marc G., and Asbun, Horacio J.

Abstract

Objective: To develop and update evidence-based and consensus-based guidelines on laparoscopic and robotic pancreatic surgery. Summary Background Data: Minimally invasive pancreatic surgery (MIPS), including laparoscopic and robotic surgery, is complex and technically demanding. Minimizing the risk for patients requires stringent, evidence-based guidelines. Since the International Miami Guidelines on MIPS in 2019, new developments and key publications have been reported, necessitating an update. Methods: Evidence-based guidelines on 22 topics in 8 domains were proposed: terminology, indications, patients, procedures, surgical techniques and instrumentation, assessment tools, implementation and training, and artificial intelligence. The Brescia Internationally Validated European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS, September 2022) used the Scottish Intercollegiate Guidelines Network (SIGN) methodology to assess the evidence and develop guideline recommendations, the Delphi method to establish consensus on the recommendations among the Expert Committee, and the AGREE II-GRS tool for guideline quality assessment and external validation by a Validation Committee. Results: Overall, 27 European experts, 6 international experts, 22 international Validation Committee members, 11 Jury Committee members, 18 Research Committee members, and 121 registered attendees of the 2-day meeting were involved in the development and validation of the guidelines. In total, 98 recommendations were developed, including 33 on laparoscopic, 34 on robotic, and 31 on general MIPS, covering 22 topics in 8 domains. Out of 98 recommendations, 97 reached at least 80% consensus among the experts and congress attendees, and all recommendations were externally validated by the Validation Committee. Conclusions: The EGUMIPS evidence-based guidelines on laparoscopic and robotic MIPS can be applied in current clinical practice to provide guidance to patients, surgeons, policy-m

Published
2024

4. Standardizing definitions and terminology of left-sided pancreatic resections through an international Delphi consensus

Author

van Ramshorst, Tess M. E., van Hilst, Jony, Boggi, Ugo, Dokmak, Safi, Edwin, Bjorn, Keck, Tobias, Khatkov, Igor, Balduzzi, Alberto, Pulvirenti, Alessandra, Ahmad, Jawad, Al Saati, Hani, Alseidi, Adnan, Ausania, Fabio, Azagra, Juan S., Balzano, Gianpaolo, Björnsson, Bergthor, Can, Fatih M., Cillo, Umberto, D'Hondt, Mathieu, Efanov, Mikhail, Erkan, Mert, Espin Alvarez, Francisco, Esposito, Alessandro, Ferrari, Giovanni, Groot Koerkamp, Bas, Gumbs, Andrew A., Hogg, Melissa E., Ielpo, Benedetto, Ivanecz, Arpad, Jang, Jin-Young, Kleive, Dyre, Kooby, David A., Luyer, Misha D. P., Marchegiani, Giovanni, Menon, Krishna, Molenaar, I. Quintus, Nagakawa, Yuichi, Nakamura, Masafumi, Palumbo, Diego, Piardi, Tullio, Ramia, Jose M., Saint-Marc, Olivier, Salti, George I, Strobel, Oliver, Vollmer, Charles M., Wei, Alice C., White, Steve, Yoon, Yoo-Seok, Zerbi, Alessandro, Bassi, Claudio, Berrevoet, Frederik, Chan, Carlos, Coimbra, Felipe J., Conlon, Kevin C. P., Dervenis, Christos, Falconi, Massimo, Frigerio, Isabella, Fusai, Giuseppe K., De Oliveira, Michelle L., Pinna, Antonio D., Primrose, John N., Sauvanet, Alain, Serrablo, Alejandro, Smadi, Sameer, Alfieri, Sergio, Berti, Stefano, Butturini, Giovanni, Casadei, Riccardo, Coppola, Roberto, Di Benedetto, Fabrizio, Ettorre, Giuseppe M., Giuliante, Felice, Jovine, Elio, Memeo, Riccardo, Pietrabissa, Andrea, Portolani, Nazario, Salvia, Roberto, Siriwardena, Ajith K., Asbun, Horacio J., Besselink, Marc G., Abu Hilal, Mohammad, van Ramshorst, Tess M. E., van Hilst, Jony, Boggi, Ugo, Dokmak, Safi, Edwin, Bjorn, Keck, Tobias, Khatkov, Igor, Balduzzi, Alberto, Pulvirenti, Alessandra, Ahmad, Jawad, Al Saati, Hani, Alseidi, Adnan, Ausania, Fabio, Azagra, Juan S., Balzano, Gianpaolo, Björnsson, Bergthor, Can, Fatih M., Cillo, Umberto, D'Hondt, Mathieu, Efanov, Mikhail, Erkan, Mert, Espin Alvarez, Francisco, Esposito, Alessandro, Ferrari, Giovanni, Groot Koerkamp, Bas, Gumbs, Andrew A., Hogg, Melissa E., Ielpo, Benedetto, Ivanecz, Arpad, Jang, Jin-Young, Kleive, Dyre, Kooby, David A., Luyer, Misha D. P., Marchegiani, Giovanni, Menon, Krishna, Molenaar, I. Quintus, Nagakawa, Yuichi, Nakamura, Masafumi, Palumbo, Diego, Piardi, Tullio, Ramia, Jose M., Saint-Marc, Olivier, Salti, George I, Strobel, Oliver, Vollmer, Charles M., Wei, Alice C., White, Steve, Yoon, Yoo-Seok, Zerbi, Alessandro, Bassi, Claudio, Berrevoet, Frederik, Chan, Carlos, Coimbra, Felipe J., Conlon, Kevin C. P., Dervenis, Christos, Falconi, Massimo, Frigerio, Isabella, Fusai, Giuseppe K., De Oliveira, Michelle L., Pinna, Antonio D., Primrose, John N., Sauvanet, Alain, Serrablo, Alejandro, Smadi, Sameer, Alfieri, Sergio, Berti, Stefano, Butturini, Giovanni, Casadei, Riccardo, Coppola, Roberto, Di Benedetto, Fabrizio, Ettorre, Giuseppe M., Giuliante, Felice, Jovine, Elio, Memeo, Riccardo, Pietrabissa, Andrea, Portolani, Nazario, Salvia, Roberto, Siriwardena, Ajith K., Asbun, Horacio J., Besselink, Marc G., and Abu Hilal, Mohammad

Abstract

Funding Agencies|Intuitive grant for the LEARNBOT European Robotic Pancreatoduodenectomy training programme; DIPLOMA-2 trial; E-MIPS Registry; Medtronic grant for the investigator-initiated DIPLOMA trial; Ethicon grant for the PANDORINA trial; Intuitive for robotic pancreatoduodenectomy training

Published
2024
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5. Implementation and outcome of minimally invasive pancreatoduodenectomy in Europe:a registry-based retrospective study A critical appraisal of the first 3 years of the E-MIPS registry

Author

Emmen, Anouk M L H, de Graaf, Nine, Khatkov, I E, Busch, O R, Dokmak, S, Boggi, Ugo, Groot Koerkamp, Bas, Ferrari, Giovanni, Molenaar, I Q, Saint-Marc, Olivier, Ramera, Marco, Lips, Daan J, Mieog, J S D, Luyer, Misha D P, Keck, Tobias, D'Hondt, Mathieu, Souche, F R, Edwin, Bjørn, Hackert, Thilo, Liem, M S L, Iben-Khayat, Abdallah, van Santvoort, H C, Mazzola, Michele, de Wilde, Roeland F, Kauffmann, E F, Aussilhou, Beatrice, Festen, Sebastiaan, Izrailov, R, Tyutyunnik, P, Besselink, M G, Abu Hilal, Mohammad, Emmen, Anouk M L H, de Graaf, Nine, Khatkov, I E, Busch, O R, Dokmak, S, Boggi, Ugo, Groot Koerkamp, Bas, Ferrari, Giovanni, Molenaar, I Q, Saint-Marc, Olivier, Ramera, Marco, Lips, Daan J, Mieog, J S D, Luyer, Misha D P, Keck, Tobias, D'Hondt, Mathieu, Souche, F R, Edwin, Bjørn, Hackert, Thilo, Liem, M S L, Iben-Khayat, Abdallah, van Santvoort, H C, Mazzola, Michele, de Wilde, Roeland F, Kauffmann, E F, Aussilhou, Beatrice, Festen, Sebastiaan, Izrailov, R, Tyutyunnik, P, Besselink, M G, and Abu Hilal, Mohammad

Abstract

BACKGROUND: International multicenter audit-based studies focusing on the outcome of minimally invasive pancreatoduodenectomy (MIPD) are lacking. The European Registry for Minimally Invasive Pancreatic Surgery (E-MIPS) is the E-AHPBA endorsed registry aimed to monitor and safeguard the introduction of MIPD in Europe. MATERIALS AND METHODS: A planned analysis of outcomes among consecutive patients after MIPD from 45 centers in 14 European countries in the E-MIPS registry (2019-2021). The main outcomes of interest were major morbidity (Clavien-Dindo grade ≥3) and 30-day/in-hospital mortality. RESULTS: Overall, 1336 patients after MIPD were included [835 robot-assisted (R-MIPD) and 501 laparoscopic MIPD (L-MIPD)]. Overall, 20 centers performed R-MIPD, 15 centers L-MIPD, and 10 centers both. Between 2019 and 2021, the rate of centers performing L-MIPD decreased from 46.9 to 25%, whereas for R-MIPD this increased from 46.9 to 65.6%. Overall, the rate of major morbidity was 41.2%, 30-day/in-hospital mortality 4.5%, conversion rate 9.7%, postoperative pancreatic fistula grade B/C 22.7%, and postpancreatectomy hemorrhage grade B/C 10.8%. Median length of hospital stay was 12 days (IQR 8-21). A lower rate of major morbidity, postoperative pancreatic fistula grade B/C, postpancreatectomy hemorrhage grade B/C, delayed gastric emptying grade B/C, percutaneous drainage, and readmission was found after L-MIPD. The number of centers meeting the Miami Guidelines volume cut-off of ≥20 MIPDs annually increased from 9 (28.1%) in 2019 to 12 (37.5%) in 2021 ( P =0.424). Rates of conversion (7.4 vs. 14.8% P <0.001) and reoperation (8.9 vs. 15.1% P <0.001) were lower in centers, which fulfilled the Miami volume cut-off. CONCLUSION: During the first 3 years of the pan-European E-MIPS registry, morbidity and mortality rates after MIPD were acceptable. A shift is ongoing from L-MIPD to R-MIPD. Variations in outcomes between the two minimally invasive approaches and the impact of the

Published
2024

6. Robot-assisted versus laparoscopic pancreatoduodenectomy:a pan-European multicenter propensity-matched study

Author

Emmen, Anouk M.L.H., Zwart, Maurice J.W., Khatkov, Igor E., Boggi, Ugo, Groot Koerkamp, Bas, Busch, Olivier R., Saint-Marc, Olivier, Dokmak, Safi, Molenaar, I. Quintus, D'Hondt, Mathieu, Ramera, Marco, Keck, Tobias, Ferrari, Giovanni, Luyer, Misha D.P., Moraldi, Luca, Ielpo, Benedetto, Wittel, Uwe, Souche, Francois Regis, Hackert, Thilo, Lips, Daan, Can, Mehmet Fatih, Bosscha, Koop, Fara, Regis, Festen, Sebastiaan, van Dieren, Susan, Coratti, Andrea, De Hingh, Ignace, Mazzola, Michele, Wellner, Ulrich, De Meyere, Celine, van Santvoort, Hjalmar C., Aussilhou, Béatrice, Ibenkhayat, Abdallah, de Wilde, Roeland F., Kauffmann, Emanuele F., Tyutyunnik, Pavel, Besselink, Marc G., Abu Hilal, Mohammad, Manzoni, Alberto, Guerra, Martina, Daams, Freek, Kazemier, Geert, Izrailov, Roman, Efanov, Mikhail, Napoli, Niccolò, Ginesini, Michael, Cappelle, Marie, Haen, Roel, Quetel, Romain, Pucci, Marco, Emmen, Anouk M.L.H., Zwart, Maurice J.W., Khatkov, Igor E., Boggi, Ugo, Groot Koerkamp, Bas, Busch, Olivier R., Saint-Marc, Olivier, Dokmak, Safi, Molenaar, I. Quintus, D'Hondt, Mathieu, Ramera, Marco, Keck, Tobias, Ferrari, Giovanni, Luyer, Misha D.P., Moraldi, Luca, Ielpo, Benedetto, Wittel, Uwe, Souche, Francois Regis, Hackert, Thilo, Lips, Daan, Can, Mehmet Fatih, Bosscha, Koop, Fara, Regis, Festen, Sebastiaan, van Dieren, Susan, Coratti, Andrea, De Hingh, Ignace, Mazzola, Michele, Wellner, Ulrich, De Meyere, Celine, van Santvoort, Hjalmar C., Aussilhou, Béatrice, Ibenkhayat, Abdallah, de Wilde, Roeland F., Kauffmann, Emanuele F., Tyutyunnik, Pavel, Besselink, Marc G., Abu Hilal, Mohammad, Manzoni, Alberto, Guerra, Martina, Daams, Freek, Kazemier, Geert, Izrailov, Roman, Efanov, Mikhail, Napoli, Niccolò, Ginesini, Michael, Cappelle, Marie, Haen, Roel, Quetel, Romain, and Pucci, Marco

Abstract

Background: The use of robot-assisted and laparoscopic pancreatoduodenectomy is increasing, yet large adjusted analyses that can be generalized internationally are lacking. This study aimed to compare outcomes after robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy in a pan-European cohort. Methods: An international multicenter retrospective study including patients after robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy from 50 centers in 12 European countries (2009–2020). Propensity score matching was performed in a 1:1 ratio. The primary outcome was major morbidity (Clavien–Dindo ≥III). Results: Among 2,082 patients undergoing minimally invasive pancreatoduodenectomy, 1,006 underwent robot-assisted pancreatoduodenectomy and 1,076 laparoscopic pancreatoduodenectomy. After matching 812 versus 812 patients, the rates of major morbidity (31.9% vs 29.6%; P = .347) and 30-day/in-hospital mortality (4.3% vs 4.6%; P = .904) did not differ significantly between robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy, respectively. Robot-assisted pancreatoduodenectomy was associated with a lower conversion rate (6.7% vs 18.0%; P < .001) and higher lymph node retrieval (16 vs 14; P = .003). Laparoscopic pancreatoduodenectomy was associated with shorter operation time (446 minutes versus 400 minutes; P < .001), and lower rates of postoperative pancreatic fistula grade B/C (19.0% vs 11.7%; P < .001), delayed gastric emptying grade B/C (21.4% vs 7.4%; P < .001), and a higher R0-resection rate (73.2% vs 84.4%; P < .001). Conclusion: This European multicenter study found no differences in overall major morbidity and 30-day/in-hospital mortality after robot-assisted pancreatoduodenectomy compared with laparoscopic pancreatoduodenectomy. Further, laparoscopic pancreatoduodenectomy was associated with a lower rate of

Published
2024

7. Implementation and outcome of minimally invasive pancreatoduodenectomy in Europe: a registry-based retrospective study - a critical appraisal of the first 3 years of the E-MIPS registry.

Author

Emmen, Anouk M. L. H., de Graaf, Nine, Khatkov, I. E., Busch, O. R., Dokmak, S., Boggi, Ugo, Koerkamp, Bas Groot, Ferrari, Giovanni, Molenaar, I. Q., Saint-Marc, Olivier, Ramera, Marco, Lips, Daan J., Mieog, J. S. D., Luyer, Misha D. P., Keck, Tobias, D'Hondt, Mathieu, Souche, F. R., Edwin, Bjørn, Hackert, Thilo, and Liem, M. S. L.

Abstract

Background: International multicenter audit-based studies focusing on the outcome of minimally invasive pancreatoduodenectomy (MIPD) are lacking. The European Registry for Minimally Invasive Pancreatic Surgery (E-MIPS) is the E-AHPBA endorsed registry aimed to monitor and safeguard the introduction of MIPD in Europe. Materials and Methods: A planned analysis of outcomes among consecutive patients after MIPD from 45 centers in 14 European countries in the E-MIPS registry (2019-2021). The main outcomes of interest were major morbidity (Clavien-Dindo grade = 3) and 30-day/in-hospital mortality. Results: Overall, 1336 patients after MIPD were included [835 robot-assisted (R-MIPD) and 501 laparoscopic MIPD (L-MIPD)]. Overall, 20 centers performed R-MIPD, 15 centers L-MIPD, and 10 centers both. Between 2019 and 2021, the rate of centers performing L-MIPD decreased from 46.9 to 25%, whereas for R-MIPD this increased from 46.9 to 65.6%. Overall, the rate of major morbidity was 41.2%, 30-day/in-hospital mortality 4.5%, conversion rate 9.7%, postoperative pancreatic fistula grade B/C 22.7%, and postpancreatectomy hemorrhage grade B/C 10.8%. Median length of hospital stay was 12 days (IQR 8-21). A lower rate of major morbidity, postoperative pancreatic fistula grade B/C, postpancreatectomy hemorrhage grade B/C, delayed gastric emptying grade B/C, percutaneous drainage, and readmission was found after L-MIPD. The number of centers meeting the Miami Guidelines volume cut-off of =20 MIPDs annually increased from 9 (28.1%) in 2019 to 12 (37.5%) in 2021 (P=0.424). Rates of conversion (7.4 vs. 14.8% P <0.001) and reoperation (8.9 vs. 15.1% P <0.001) were lower in centers, which fulfilled the Miami volume cut-off. Conclusion: During the first 3 years of the pan-European E-MIPS registry, morbidity and mortality rates after MIPD were acceptable. A shift is ongoing from L-MIPD to R-MIPD. Variations in outcomes between the two minimally invasive approaches and the impact of the volume cut-off should be further evaluated over a longer time period. [ABSTRACT FROM AUTHOR]

Published
2024
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8. The Feasibility, Proficiency, and Mastery Learning Curves in 635 Robotic Pancreatoduodenectomies Following A Multicenter Training Program: 'Standing on the Shoulders of Giants'

Author

Zwart, Maurice J W, van den Broek, Bram, de Graaf, Nine, Suurmeijer, J Annelie, Augustinus, Simone, Te Riele, Wouter W, van Santvoort, Hjalmar C, Hagendoorn, Jeroen, Borel Rinkes, Inne H M, van Dam, Jacob L, Takagi, Kosei, Tran, T C Khé, Schreinemakers, Jennifer, van der Schelling, George, Wijsman, Jan H, de Wilde, Roeland F, Festen, Sebastiaan, Daams, Freek, Luyer, Misha D, de Hingh, Ignace H J T, Mieog, J Sven D, Bonsing, Bert A, Lips, Daan J, Hilal, M Abu, Busch, Olivier R, Saint-Marc, Olivier, Zeh, Herbert J, Zureikat, Amer H, Hogg, Melissa E, Koerkamp, Bas Groot, Molenaar, I Quintus, Besselink, Marc G, Zwart, Maurice J W, van den Broek, Bram, de Graaf, Nine, Suurmeijer, J Annelie, Augustinus, Simone, Te Riele, Wouter W, van Santvoort, Hjalmar C, Hagendoorn, Jeroen, Borel Rinkes, Inne H M, van Dam, Jacob L, Takagi, Kosei, Tran, T C Khé, Schreinemakers, Jennifer, van der Schelling, George, Wijsman, Jan H, de Wilde, Roeland F, Festen, Sebastiaan, Daams, Freek, Luyer, Misha D, de Hingh, Ignace H J T, Mieog, J Sven D, Bonsing, Bert A, Lips, Daan J, Hilal, M Abu, Busch, Olivier R, Saint-Marc, Olivier, Zeh, Herbert J, Zureikat, Amer H, Hogg, Melissa E, Koerkamp, Bas Groot, Molenaar, I Quintus, and Besselink, Marc G

Abstract

OBJECTIVE: To assess the feasibility, proficiency, and mastery learning curves for robotic pancreatoduodenectomy (RPD) in "second-generation" RPD centers following a multicenter training program adhering to the IDEAL framework. BACKGROUND: The long learning curves for RPD reported from "pioneering" expert centers may discourage centers interested in starting an RPD program. However, the feasibility, proficiency, and mastery learning curves may be shorter in "second-generation" centers that participated in dedicated RPD training programs, although data are lacking. We report on the learning curves for RPD in "second-generation" centers trained in a dedicated nationwide program. METHODS: Post hoc analysis of all consecutive patients undergoing RPD in 7 centers that participated in the LAELAPS-3 training program, each with a minimum annual volume of 50 pancreatoduodenectomies, using the mandatory Dutch Pancreatic Cancer Audit (March 2016-December 2021). Cumulative sum analysis determined cutoffs for the 3 learning curves: operative time for the feasibility (1) risk-adjusted major complication (Clavien-Dindo grade ≥III) for the proficiency, (2) and textbook outcome for the mastery, (3) learning curve. Outcomes before and after the cutoffs were compared for the proficiency and mastery learning curves. A survey was used to assess changes in practice and the most valued "lessons learned." RESULTS: Overall, 635 RPD were performed by 17 trained surgeons, with a conversion rate of 6.6% (n=42). The median annual volume of RPD per center was 22.5±6.8. From 2016 to 2021, the nationwide annual use of RPD increased from 0% to 23% whereas the use of laparoscopic pancreatoduodenectomy decreased from 15% to 0%. The rate of major complications was 36.9% (n=234), surgical site infection 6.3% (n=40), postoperative pancreatic fistula (grade B/C) 26.9% (n=171), and 30-day/in-hospital mortality 3.5% (n=22). Cutoffs for the feasibility, proficiency, and mastery learning curves were reach

Published
2023

9. Robotic Distal Pancreatectomy, a Novel Standard of Care?:Benchmark Values for Surgical Outcomes from 16 International Expert Centers

Author

Müller, Philip C, Breuer, Eva, Nickel, Felix, Zani, Sabino, Kauffmann, Emanuele, De Franco, Lorenzo, Tschuor, Christoph, Suno Krohn, Paul, Burgdorf, Stefan K, Jonas, Jan Philipp, Oberkofler, Christian E, Petrowsky, Henrik, Saint-Marc, Olivier, Seelen, Leonard, Molenaar, Izaak Quintus, Wellner, Ulrich, Keck, Tobias, Coratti, Andrea, van Dam, Coen, de Wilde, Roeland, Koerkamp, Bas Groot, Valle, Valentina, Giulianotti, Pier, Ghabi, Elie, Moskal, David, Lavu, Harish, Vrochides, Dionisios, Martinie, John, Yeo, Charles, Sánchez-Velázquez, Patricia, Ielpo, Benedetto, Ajay, Pranay S, Shah, Mihir M, Kooby, David A, Gao, Song, Hao, Jihui, He, Jin, Boggi, Ugo, Hackert, Thilo, Allen, Peter, Borel-Rinkes, Inne H M, Clavien, Pierre Alain, Müller, Philip C, Breuer, Eva, Nickel, Felix, Zani, Sabino, Kauffmann, Emanuele, De Franco, Lorenzo, Tschuor, Christoph, Suno Krohn, Paul, Burgdorf, Stefan K, Jonas, Jan Philipp, Oberkofler, Christian E, Petrowsky, Henrik, Saint-Marc, Olivier, Seelen, Leonard, Molenaar, Izaak Quintus, Wellner, Ulrich, Keck, Tobias, Coratti, Andrea, van Dam, Coen, de Wilde, Roeland, Koerkamp, Bas Groot, Valle, Valentina, Giulianotti, Pier, Ghabi, Elie, Moskal, David, Lavu, Harish, Vrochides, Dionisios, Martinie, John, Yeo, Charles, Sánchez-Velázquez, Patricia, Ielpo, Benedetto, Ajay, Pranay S, Shah, Mihir M, Kooby, David A, Gao, Song, Hao, Jihui, He, Jin, Boggi, Ugo, Hackert, Thilo, Allen, Peter, Borel-Rinkes, Inne H M, and Clavien, Pierre Alain

Abstract

Background and Objective: Robotic distal pancreatectomy (DP) is an emerging attractive approach, but its role compared with laparoscopic or open surgery remains unclear. Benchmark values are novel and objective tools for such comparisons. The aim of this study was to identify benchmark cutoffs for many outcome parameters for DP with or without splenectomy beyond the learning curve. Methods: This study analyzed outcomes from international expert centers from patients undergoing robotic DP for malignant or benign lesions. After excluding the first 10 cases in each center to reduce the effect of the learning curve, consecutive patients were included from the start of robotic DP up to June 2020. Benchmark patients had no significant comorbidities. Benchmark cutoff values were derived from the 75th or the 25th percentile of the median values of all benchmark centers. Benchmark values were compared with a laparoscopic control group from 4 high-volume centers and published open DP landmark series. Results: Sixteen centers contributed 755 cases, whereof 345 benchmark patients (46%) were included the analysis. Benchmark cutoffs included: operation time ≤300 minutes, conversion rate ≤3%, clinically relevant postoperative pancreatic fistula ≤32%, 3 months major complication rate ≤26.7%, and lymph node retrieval ≥9. The comprehensive complication index at 3 months was ≤8.7 without deterioration thereafter. Compared with robotic DP, laparoscopy had significantly higher conversion rates (5×) and overall complications, while open DP was associated with more blood loss and longer hospital stay. Conclusion: This first benchmark study demonstrates that robotic DP provides superior postoperative outcomes compared with laparoscopic and open DP. Robotic DP may be expected to become the approach of choice in minimally invasive DP.

Published
2023

10. The PD-ROBOSCORE:A difficulty score for robotic pancreatoduodenectomy

Author

Napoli, Niccolò, Cacace, Concetta, Kauffmann, Emanuele F., Jones, Leia, Ginesini, Michael, Gianfaldoni, Cesare, Salamone, Alice, Asta, Fabio, Ripolli, Allegra, Di Dato, Armando, Busch, Olivier R., Cappelle, Marie L., Chao, Ying Jui, de Wilde, Roeland F., Hackert, Thilo, Jang, Jin Young, Koerkamp, Bas Groot, Kwon, Wooil, Lips, Daan, Luyer, Misha D.P., Nickel, Felix, Saint-Marc, Olivier, Shan, Yan Shen, Shen, Baiyong, Vistoli, Fabio, Besselink, Marc G., Hilal, Mohammad Abu, Boggi, Ugo, Napoli, Niccolò, Cacace, Concetta, Kauffmann, Emanuele F., Jones, Leia, Ginesini, Michael, Gianfaldoni, Cesare, Salamone, Alice, Asta, Fabio, Ripolli, Allegra, Di Dato, Armando, Busch, Olivier R., Cappelle, Marie L., Chao, Ying Jui, de Wilde, Roeland F., Hackert, Thilo, Jang, Jin Young, Koerkamp, Bas Groot, Kwon, Wooil, Lips, Daan, Luyer, Misha D.P., Nickel, Felix, Saint-Marc, Olivier, Shan, Yan Shen, Shen, Baiyong, Vistoli, Fabio, Besselink, Marc G., Hilal, Mohammad Abu, and Boggi, Ugo

Abstract

Background: Difficulty scoring systems are important for the safe, stepwise implementation of new procedures. We designed a retrospective observational study for building a difficulty score for robotic pancreatoduodenectomy. Methods: The difficulty score (PD-ROBOSCORE) aims at predicting severe postoperative complications after robotic pancreatoduodenectomy. The PD-ROBOSCORE was developed in a training cohort of 198 robotic pancreatoduodenectomies and was validated in an international multicenter cohort of 686 robotic pancreatoduodenectomies. Finally, all centers tested the model during the early learning curve (n = 300). Growing difficulty levels (low, intermediate, high) were defined using cut-off values set at the 33rd and 66th percentile (NCT04662346). Results: Factors included in the final multivariate model were a body mass index of ≥25 kg/m2 for males and ≥30 kg/m2 for females (odds ratio:2.39; P < .0001), borderline resectable tumor (odd ratio:1.98; P < .0001), uncinate process tumor (odds ratio:1.69; P < .0001), pancreatic duct size <4 mm (odds ratio:1.59; P < .0001), American Society of Anesthesiologists class ≥3 (odds ratio:1.59; P < .0001), and hepatic artery originating from the superior mesenteric artery (odds ratio:1.43; P < .0001). In the training cohort, the absolute score value (odds ratio = 1.13; P = .0089) and difficulty groups (odds ratio = 2.35; P = .041) predicted severe postoperative complications. In the multicenter validation cohort, the absolute score value predicted severe postoperative complications (odds ratio = 1.16, P < .001), whereas the difficulty groups did not (odds ratio = 1.94, P = .082). In the learning curve cohort, both absolute score value (odds ratio:1.078, P = .04) and difficulty groups (odds ratio: 2.25, P = .017) predicted severe postoperative complications. Across all cohorts, a PD-ROBOSCORE of ≥12.51 doubled the risk of severe postoperative complications. The PD-ROBOSCOR

Published
2023

11. The Feasibility, Proficiency, and Mastery Learning Curves in 635 Robotic Pancreatoduodenectomies Following a Multicenter Training Program: 'standing on the Shoulders of Giants'

Author

CTC, MS CGO, MS HOD, Cancer, Regenerative Medicine and Stem Cells, Zwart, Maurice J.W., Van Den Broek, Bram, De Graaf, Nine, Suurmeijer, José A., Augustinus, Simone, Te Riele, Wouter W., Van Santvoort, Hjalmar C., Hagendoorn, Jeroen, Borel Rinkes, Inne H.M., Van Dam, Jacob L., Takagi, Kosei, Tran, Khé T.C., Schreinemakers, Jennifer, Van Der Schelling, George, Wijsman, Jan H., De Wilde, Roeland F., Festen, Sebastiaan, Daams, Freek, Luyer, Misha D., De Hingh, Ignace H.J.T., Mieog, Jan S.D., Bonsing, Bert A., Lips, Daan J., Abu Hilal, Mohamed, Busch, Olivier R., Saint-Marc, Olivier, Zeh, Herbert J., Zureikat, Amer H., Hogg, Melissa E., Koerkamp, Bas G., Molenaar, Isaac Q., Besselink, Marc G., CTC, MS CGO, MS HOD, Cancer, Regenerative Medicine and Stem Cells, Zwart, Maurice J.W., Van Den Broek, Bram, De Graaf, Nine, Suurmeijer, José A., Augustinus, Simone, Te Riele, Wouter W., Van Santvoort, Hjalmar C., Hagendoorn, Jeroen, Borel Rinkes, Inne H.M., Van Dam, Jacob L., Takagi, Kosei, Tran, Khé T.C., Schreinemakers, Jennifer, Van Der Schelling, George, Wijsman, Jan H., De Wilde, Roeland F., Festen, Sebastiaan, Daams, Freek, Luyer, Misha D., De Hingh, Ignace H.J.T., Mieog, Jan S.D., Bonsing, Bert A., Lips, Daan J., Abu Hilal, Mohamed, Busch, Olivier R., Saint-Marc, Olivier, Zeh, Herbert J., Zureikat, Amer H., Hogg, Melissa E., Koerkamp, Bas G., Molenaar, Isaac Q., and Besselink, Marc G.

Published
2023

12. Robotic Distal Pancreatectomy, a Novel Standard of Care?: Benchmark Values for Surgical Outcomes from 16 International Expert Centers

Author

Cancer, MS CGO, Regenerative Medicine and Stem Cells, Müller, Philip C, Breuer, Eva, Nickel, Felix, Zani, Sabino, Kauffmann, Emanuele, De Franco, Lorenzo, Tschuor, Christoph, Suno Krohn, Paul, Burgdorf, Stefan K, Jonas, Jan Philipp, Oberkofler, Christian E, Petrowsky, Henrik, Saint-Marc, Olivier, Seelen, Leonard, Molenaar, Izaak Quintus, Wellner, Ulrich, Keck, Tobias, Coratti, Andrea, van Dam, Coen, de Wilde, Roeland, Koerkamp, Bas Groot, Valle, Valentina, Giulianotti, Pier, Ghabi, Elie, Moskal, David, Lavu, Harish, Vrochides, Dionisios, Martinie, John, Yeo, Charles, Sánchez-Velázquez, Patricia, Ielpo, Benedetto, Ajay, Pranay S, Shah, Mihir M, Kooby, David A, Gao, Song, Hao, Jihui, He, Jin, Boggi, Ugo, Hackert, Thilo, Allen, Peter, Borel-Rinkes, Inne H M, Clavien, Pierre Alain, Cancer, MS CGO, Regenerative Medicine and Stem Cells, Müller, Philip C, Breuer, Eva, Nickel, Felix, Zani, Sabino, Kauffmann, Emanuele, De Franco, Lorenzo, Tschuor, Christoph, Suno Krohn, Paul, Burgdorf, Stefan K, Jonas, Jan Philipp, Oberkofler, Christian E, Petrowsky, Henrik, Saint-Marc, Olivier, Seelen, Leonard, Molenaar, Izaak Quintus, Wellner, Ulrich, Keck, Tobias, Coratti, Andrea, van Dam, Coen, de Wilde, Roeland, Koerkamp, Bas Groot, Valle, Valentina, Giulianotti, Pier, Ghabi, Elie, Moskal, David, Lavu, Harish, Vrochides, Dionisios, Martinie, John, Yeo, Charles, Sánchez-Velázquez, Patricia, Ielpo, Benedetto, Ajay, Pranay S, Shah, Mihir M, Kooby, David A, Gao, Song, Hao, Jihui, He, Jin, Boggi, Ugo, Hackert, Thilo, Allen, Peter, Borel-Rinkes, Inne H M, and Clavien, Pierre Alain

Published
2023

13. Robotic Distal Pancreatectomy:A Novel Standard of Care? Benchmark Values for Surgical Outcomes from 16 International Expert Centers

Author

Müller, Philip C., Breuer, Eva, Nickel, Felix, Zani, Sabino, Kauffmann, Emanuele, De Franco, Lorenzo, Tschuor, Christoph, Krohn, Paul Suno, Burgdorf, Stefan K., Jonas, Jan Philipp, Oberkofler, Christian E., Petrowsky, Henrik, Saint-Marc, Olivier, Seelen, Leonard, Molenaar, Izaak Quintus, Wellner, Ulrich, Keck, Tobias, Coratti, Andrea, Van Dam, Jacob L., De Wilde, Roeland, Koerkamp, Bas Groot, Valle, Valentina, Giulianotti, Pier, Ghabi, Elie, Moskal, David, Lavu, Harish, Vrochides, Dionisios, Martinie, John, Yeo, Charles, Sánchez-velázquez, Patricia, Ielpo, Benedetto, Ajay, Pranay S., Shah, Mihir M., Kooby, David A., Gao, Song, Hao, Jihui, He, Jin, Boggi, Ugo, Hackert, Thilo, Allen, Peter, Borel-rinkes, Inne H.m., Clavien, Pierre Alain, Müller, Philip C., Breuer, Eva, Nickel, Felix, Zani, Sabino, Kauffmann, Emanuele, De Franco, Lorenzo, Tschuor, Christoph, Krohn, Paul Suno, Burgdorf, Stefan K., Jonas, Jan Philipp, Oberkofler, Christian E., Petrowsky, Henrik, Saint-Marc, Olivier, Seelen, Leonard, Molenaar, Izaak Quintus, Wellner, Ulrich, Keck, Tobias, Coratti, Andrea, Van Dam, Jacob L., De Wilde, Roeland, Koerkamp, Bas Groot, Valle, Valentina, Giulianotti, Pier, Ghabi, Elie, Moskal, David, Lavu, Harish, Vrochides, Dionisios, Martinie, John, Yeo, Charles, Sánchez-velázquez, Patricia, Ielpo, Benedetto, Ajay, Pranay S., Shah, Mihir M., Kooby, David A., Gao, Song, Hao, Jihui, He, Jin, Boggi, Ugo, Hackert, Thilo, Allen, Peter, Borel-rinkes, Inne H.m., and Clavien, Pierre Alain

Abstract

Background and Objective: Robotic distal pancreatectomy (DP) is an emerging attractive approach, but its role compared to laparoscopic or open surgery remains unclear. Benchmark values are novel and objective tools for such comparisons. The aim of this study was to identify benchmark cutoffs for many outcome parameters for DP with or without splenectomy beyond the learning curve. Methods: This study analyzed outcomes from international expert centers from patients undergoing robotic DP for malignant or benign lesions. After excluding the first 10 cases in each center to reduce the effect of the learning curve, consecutive patients were included from the start of robotic DP up to June 2020. Benchmark patients had no significant comorbidities. Benchmark cutoff values were derived from the 75th or the 25th percentile of the median values of all benchmark centers. Benchmark values were compared to a laparoscopic control group from four high-volume centers and published open DP landmark series. Results: Sixteen centers contributed 755 cases, whereof 345 benchmark patients (46%) were included the analysis. Benchmark cut-offs included: operation time ≤300min, conversion rate ≤3%, clinically relevant POPF ≤32%, 3 months major complication rate ≤26.7% and lymph node retrieval ≥9. The CCI® at 3 months was ≤8.7 without deterioration thereafter. Compared to robotic DP, laparoscopy had significantly higher conversion rates (5x) and overall complications, while open DP was associated with more blood loss and longer hospital stay. Conclusion: This first benchmark study demonstrates that robotic DP provides superior postoperative outcomes compared to laparoscopic and open DP. Robotic DP may be expected to become the approach of choice in minimally invasive DP.

Published
2023

14. Use and outcome of minimally invasive pancreatic surgery in the European E-MIPS registry

Author

van der Heijde, Nicky, primary, Vissers, Frederique L., additional, Manzoni, Alberto, additional, Zimmitti, Giuseppe, additional, Balsells, Joaquim, additional, Berrevoet, Frederik, additional, Bjornsson, Bergthor, additional, van den Boezem, Peter, additional, Boggi, Ugo, additional, Bratlie, Svein O., additional, Burdio, Fernando, additional, Coratti, Andrea, additional, D'Hondt, Mathieu, additional, Del Pozo, Carlos D., additional, Dokmak, Safi, additional, Fara, Regis, additional, Can, Mehmet F., additional, Festen, Sebastiaan, additional, Forgione, Antonello, additional, Fristrup, Claus, additional, Gaujoux, Sebastien, additional, Koerkamp, Bas G., additional, Hackert, Thilo, additional, Khatkov, Igor E., additional, Keck, Tobias, additional, Seppänen, Hanna, additional, Lips, Daan, additional, Luyer, Misha, additional, Pittau, Gabriella, additional, Maglione, Manuel, additional, Molenaar, I.Q., additional, Pessaux, Patrick, additional, Roeyen, Geert, additional, Saint-Marc, Olivier, additional, Cabus, Santiago S., additional, van Santvoort, Hjalmar, additional, van der Schelling, George, additional, Martin, Mario S., additional, Souche, Francois-regis, additional, Suarez Muñoz, Miguel Á., additional, Marino, Marco V., additional, Besselink, Marc G., additional, Hilal, Mohammed A., additional, Vilhav, Caroline, additional, Hartman, Vera, additional, Kirkegård, Jakob, additional, Sergeant, Gregory, additional, Kleeff, Jörg, additional, Coolsen, Marielle, additional, Coppola, Roberto, additional, Pauletti, Bruno, additional, Mittermair, Christof, additional, Tingstedt, Bobby, additional, Erkan, Mert, additional, Tomazic, Ales, additional, and Korkolis, Dimitris, additional

Published
2022
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15. Robotic Distal Pancreatectomy, a Novel Standard of Care?:Benchmark Values for Surgical Outcomes from 16 International Expert Centers

Author

Müller, Philip C, Breuer, Eva, Nickel, Felix, Zani, Sabino, Kauffmann, Emanuele, De Franco, Lorenzo, Tschuor, Christoph, Suno Krohn, Paul, Burgdorf, Stefan K, Jonas, Jan Philipp, Oberkofler, Christian E, Petrowsky, Henrik, Saint-Marc, Olivier, Seelen, Leonard, Molenaar, Izaak Quintus, Wellner, Ulrich, Keck, Tobias, Coratti, Andrea, van Dam, Coen, de Wilde, Roeland, Koerkamp, Bas Groot, Valle, Valentina, Giulianotti, Pier, Ghabi, Elie, Moskal, David, Lavu, Harish, Vrochides, Dionisios, Martinie, John, Yeo, Charles, Sánchez-Velázquez, Patricia, Ielpo, Benedetto, Ajay, Pranay S, Shah, Mihir M, Kooby, David A, Gao, Song, Hao, Jihui, He, Jin, Boggi, Ugo, Hackert, Thilo, Allen, Peter, Borel-Rinkes, Inne H M, Clavien, Pierre Alain, Müller, Philip C, Breuer, Eva, Nickel, Felix, Zani, Sabino, Kauffmann, Emanuele, De Franco, Lorenzo, Tschuor, Christoph, Suno Krohn, Paul, Burgdorf, Stefan K, Jonas, Jan Philipp, Oberkofler, Christian E, Petrowsky, Henrik, Saint-Marc, Olivier, Seelen, Leonard, Molenaar, Izaak Quintus, Wellner, Ulrich, Keck, Tobias, Coratti, Andrea, van Dam, Coen, de Wilde, Roeland, Koerkamp, Bas Groot, Valle, Valentina, Giulianotti, Pier, Ghabi, Elie, Moskal, David, Lavu, Harish, Vrochides, Dionisios, Martinie, John, Yeo, Charles, Sánchez-Velázquez, Patricia, Ielpo, Benedetto, Ajay, Pranay S, Shah, Mihir M, Kooby, David A, Gao, Song, Hao, Jihui, He, Jin, Boggi, Ugo, Hackert, Thilo, Allen, Peter, Borel-Rinkes, Inne H M, and Clavien, Pierre Alain

Abstract

BACKGROUND AND OBJECTIVE: Robotic distal pancreatectomy (DP) is an emerging attractive approach, but its role compared to laparoscopic or open surgery remains unclear. Benchmark values are novel and objective tools for such comparisons. The aim of this study was to identify benchmark cutoffs for many outcome parameters for DP with or without splenectomy beyond the learning curve.METHODS: This study analyzed outcomes from international expert centers from patients undergoing robotic DP for malignant or benign lesions. After excluding the first 10 cases in each center to reduce the effect of the learning curve, consecutive patients were included from the start of robotic DP up to June 2020. Benchmark patients had no significant comorbidities. Benchmark cutoff values were derived from the 75 th or the 25 th percentile of the median values of all benchmark centers. Benchmark values were compared to a laparoscopic control group from four high-volume centers and published open DP landmark series.RESULTS: Sixteen centers contributed 755 cases, whereof 345 benchmark patients (46%) were included the analysis. Benchmark cut-offs included: operation time ≤300min, conversion rate ≤3%, clinically relevant POPF ≤32%, 3 months major complication rate ≤26.7% and lymph node retrieval ≥9. The CCI ® at 3 months was ≤8.7 without deterioration thereafter. Compared to robotic DP, laparoscopy had significantly higher conversion rates (5x) and overall complications, while open DP was associated with more blood loss and longer hospital stay.CONCLUSION: This first benchmark study demonstrates that robotic DP provides superior postoperative outcomes compared to laparoscopic and open DP. Robotic DP may be expected to become the approach of choice in minimally invasive DP.

Published
2022

16. Minimally invasive versus open distal pancreatectomy for pancreatic ductal adenocarcinoma (DIPLOMA) : study protocol for a randomized controlled trial

Author

van Hilst, Jony, Korrel, Maarten, Lof, Sanne, de Rooij, Thijs, Vissers, Frederique, Al-Sarireh, Bilal, Alseidi, Adnan, Bateman, Adrian C., Björnsson, Bergthor, Boggi, Ugo, Bratlie, Svein Olav, Busch, Olivier, Butturini, Giovanni, Casadei, Riccardo, Dijk, Frederike, Dokmak, Safi, Edwin, Bjorn, van Eijck, Casper, Esposito, Alessandro, Fabre, Jean-Michel, Falconi, Massimo, Ferrari, Giovanni, Fuks, David, Koerkamp, Bas Groot, Hackert, Thilo, Keck, Tobias, Khatkov, Igor, de Kleine, Ruben, Kokkola, Arto, Kooby, David A., Lips, Daan, Luyer, Misha, Marudanayagam, Ravi, Menon, Krishna, Molenaar, Quintus, de Pastena, Matteo, Pietrabissa, Andrea, Rajak, Rushda, Rosso, Edoardo, Sanchez Velazquez, Patricia, Saint Marc, Olivier, Shah, Mihir, Soonawalla, Zahir, Tomazic, Ales, Verbeke, Caroline, Verheij, Joanne, White, Steven, Wilmink, Hanneke W., Zerbi, Alessandro, Dijkgraaf, Marcel G., Besselink, Marc G., Abu Hilal, Mohammad, van Hilst, Jony, Korrel, Maarten, Lof, Sanne, de Rooij, Thijs, Vissers, Frederique, Al-Sarireh, Bilal, Alseidi, Adnan, Bateman, Adrian C., Björnsson, Bergthor, Boggi, Ugo, Bratlie, Svein Olav, Busch, Olivier, Butturini, Giovanni, Casadei, Riccardo, Dijk, Frederike, Dokmak, Safi, Edwin, Bjorn, van Eijck, Casper, Esposito, Alessandro, Fabre, Jean-Michel, Falconi, Massimo, Ferrari, Giovanni, Fuks, David, Koerkamp, Bas Groot, Hackert, Thilo, Keck, Tobias, Khatkov, Igor, de Kleine, Ruben, Kokkola, Arto, Kooby, David A., Lips, Daan, Luyer, Misha, Marudanayagam, Ravi, Menon, Krishna, Molenaar, Quintus, de Pastena, Matteo, Pietrabissa, Andrea, Rajak, Rushda, Rosso, Edoardo, Sanchez Velazquez, Patricia, Saint Marc, Olivier, Shah, Mihir, Soonawalla, Zahir, Tomazic, Ales, Verbeke, Caroline, Verheij, Joanne, White, Steven, Wilmink, Hanneke W., Zerbi, Alessandro, Dijkgraaf, Marcel G., Besselink, Marc G., and Abu Hilal, Mohammad

Abstract

Background: Recently, the first randomized trials comparing minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) for non-malignant and malignant disease showed a 2-day reduction in time to functional recovery after MIDP. However, for pancreatic ductal adenocarcinoma (PDAC), concerns have been raised regarding the oncologic safety (i.e., radical resection, lymph node retrieval, and survival) of MIDP, as compared to ODP. Therefore, a randomized controlled trial comparing MIDP and ODP in PDAC regarding oncological safety is warranted. We hypothesize that the microscopically radical resection (R0) rate is non-inferior for MIDP, as compared to ODP. Methods/design: DIPLOMA is an international randomized controlled, patient- and pathologist-blinded, non-inferiority trial performed in 38 pancreatic centers in Europe and the USA. A total of 258 patients with an indication for elective distal pancreatectomy with splenectomy because of proven or highly suspected PDAC of the pancreatic body or tail will be randomly allocated to MIDP (laparoscopic or robot-assisted) or ODP in a 1:1 ratio. The primary outcome is the microscopically radical resection margin (R0, distance tumor to pancreatic transection and posterior margin >= 1 mm), which is assessed using a standardized histopathology assessment protocol. The sample size is calculated with the following assumptions: 5% one-sided significance level (alpha), 80% power (1-beta), expected R0 rate in the open group of 58%, expected R0 resection rate in the minimally invasive group of 67%, and a non-inferiority margin of 7%. Secondary outcomes include time to functional recovery, operative outcomes (e.g., blood loss, operative time, and conversion to open surgery), other histopathology findings (e.g., lymph node retrieval, perineural- and lymphovascular invasion), postoperative outcomes (e.g., clinically relevant complications, hospital stay, and administration of adjuvant treatment), time and si, Funding Agencies|Covidien AG (Medtronic, Neuhausen am Rheinfall, Switzerland) [ISR2017-10928]

Published
2021
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17. Outcomes After Minimally-invasive Versus Open Pancreatoduodenectomy A Pan-European Propensity Score Matched Study

Author

MS CGO, Cancer, Klompmaker, Sjors, van Hilst, Jony, Wellner, Ulrich F., Busch, Olivier R., Coratti, Andrea, D'Hondt, Mathieu, Dokmak, Safi, Festen, Sebastiaan, Kerem, Mustafa, Khatkov, Igor, Lips, Daan J., Lombardo, Carlo, Luyer, Misha, Manzoni, Alberto, Molenaar, Izaak Q., Rosso, Edoardo, Saint-Marc, Olivier, Vansteenkiste, Franky, Wittel, Uwe A., Bonsing, Bert, Koerkamp, Bas Groot, Abu Hilal, Mohammed, Fuks, David, Poves, Ignasi, Keck, Tobias, Boggi, Ugo, Besselink, Marc G., MS CGO, Cancer, Klompmaker, Sjors, van Hilst, Jony, Wellner, Ulrich F., Busch, Olivier R., Coratti, Andrea, D'Hondt, Mathieu, Dokmak, Safi, Festen, Sebastiaan, Kerem, Mustafa, Khatkov, Igor, Lips, Daan J., Lombardo, Carlo, Luyer, Misha, Manzoni, Alberto, Molenaar, Izaak Q., Rosso, Edoardo, Saint-Marc, Olivier, Vansteenkiste, Franky, Wittel, Uwe A., Bonsing, Bert, Koerkamp, Bas Groot, Abu Hilal, Mohammed, Fuks, David, Poves, Ignasi, Keck, Tobias, Boggi, Ugo, and Besselink, Marc G.

Published
2020

18. Análisis de situación, propuesta e implementación de mejoras en la gestión de un almacén de material de no producción de la planta de Almussafes de Ford España S.L

Author

Saint-Marc, Olivier Jean Baptiste

Subjects
Almacén, Digitalization, Gestión, Warehouse, Management, Organización, Máster Universitario en Ingeniería Industrial-Màster Universitari en Enginyeria Industrial, Automoción, Automobile, Digitalización, Improvement, ORGANIZACION DE EMPRESAS, Agilización, Organization
Abstract

[ES] El presente Trabajo de fin de Máster pretende agilizar la gestión de un almacén de material de no producción de la planta de Almussafes de Ford S.L. mediante unas implementaciones de mejora. Para entender las necesidades actuales del departamento de la empresa, se describirá el entorno de este ultimo y se analizará su situación actual. Tras realizar este análisis, se estudiarán las incidencias, sus causas y las potenciales medidas que se podrían tomar para resolverlas. A continuación, después de realizar un análisis de datos, se crearán unas reglas de organización física del almacén. Luego, se propondrá un cambio del sistema de identificación del material en el almacén para asegurar el buen seguimiento del material a mejor precio. En fin, se desarrollará por una parte la lógica de funcionamiento de una aplicación de gestión de almacén, y por otra parte su ergonomía para asegurar un uso sencillo., [EN] The objective of this Master Thesis is improving the management of a non-production material warehouse at Ford España S.L. through the implementation of several measures. To reach this objective, the environment of the problem will be explained. The department and its current situation will be analyzed to identify the causes and potential solutions to the problem. Through a study of data, some rules will be proposed to physically reorder the warehouse. In addition to that, the identification system of the material will be changed to reduce its cost and improve its efficiency. Finally, an application will be designed to help the labor force in their daily operations in stock management. On the one hand, its logic will be developed in order to ensure the respect of all the requirements, and on the other hand, its design will be drawn to ensure an easy use of such an application., [CA] El present Treball de fi de Màster pretén agilitzar la gestió d’un magatzem de materials de producció de la planta d’Almussafes de Ford S.L. mitjançant unes implementacions de millora. Per a entendre les necessitats actuals del departament de l’empresa, es descriurà l’entorn d’aquest últim y s’analitzarà la seua situació actual. Després de realitzar aquest anàlisis, s'estudiaran les incidències, les seues causes i les potencials mesures que es podrien prendre per a resoldre-les. A continuació, després de realitzar una anàlisi de dades, es crearan unes regles d'organització física del magatzem. Després, es proposarà un canvi del sistema d'identificació del material en el magatzem per a assegurar el bon seguiment del material a millor preu. En fi, es desenvoluparà d'una banda la lògica de funcionament d'una aplicació de gestió de magatzem, i d'altra banda la seva ergonomia per a assegurar un ús senzill.

Published
2019

19. Análisis de situación, propuesta e implementación de mejoras en la gestión de un almacén de material de no producción de la planta de Almussafes de Ford España S.L

Author

Maheut, Julien Philippe Dominique, García Sabater, José Pedro, Universitat Politècnica de València. Departamento de Organización de Empresas - Departament d'Organització d'Empreses, Universitat Politècnica de València. Escuela Técnica Superior de Ingenieros Industriales - Escola Tècnica Superior d'Enginyers Industrials, Saint-Marc, Olivier Jean Baptiste, Maheut, Julien Philippe Dominique, García Sabater, José Pedro, Universitat Politècnica de València. Departamento de Organización de Empresas - Departament d'Organització d'Empreses, Universitat Politècnica de València. Escuela Técnica Superior de Ingenieros Industriales - Escola Tècnica Superior d'Enginyers Industrials, and Saint-Marc, Olivier Jean Baptiste

Abstract

[ES] El presente Trabajo de fin de Máster pretende agilizar la gestión de un almacén de material de no producción de la planta de Almussafes de Ford S.L. mediante unas implementaciones de mejora. Para entender las necesidades actuales del departamento de la empresa, se describirá el entorno de este ultimo y se analizará su situación actual. Tras realizar este análisis, se estudiarán las incidencias, sus causas y las potenciales medidas que se podrían tomar para resolverlas. A continuación, después de realizar un análisis de datos, se crearán unas reglas de organización física del almacén. Luego, se propondrá un cambio del sistema de identificación del material en el almacén para asegurar el buen seguimiento del material a mejor precio. En fin, se desarrollará por una parte la lógica de funcionamiento de una aplicación de gestión de almacén, y por otra parte su ergonomía para asegurar un uso sencillo., [EN] The objective of this Master Thesis is improving the management of a non-production material warehouse at Ford España S.L. through the implementation of several measures. To reach this objective, the environment of the problem will be explained. The department and its current situation will be analyzed to identify the causes and potential solutions to the problem. Through a study of data, some rules will be proposed to physically reorder the warehouse. In addition to that, the identification system of the material will be changed to reduce its cost and improve its efficiency. Finally, an application will be designed to help the labor force in their daily operations in stock management. On the one hand, its logic will be developed in order to ensure the respect of all the requirements, and on the other hand, its design will be drawn to ensure an easy use of such an application., [CA] El present Treball de fi de Màster pretén agilitzar la gestió d’un magatzem de materials de producció de la planta d’Almussafes de Ford S.L. mitjançant unes implementacions de millora. Per a entendre les necessitats actuals del departament de l’empresa, es descriurà l’entorn d’aquest últim y s’analitzarà la seua situació actual. Després de realitzar aquest anàlisis, s'estudiaran les incidències, les seues causes i les potencials mesures que es podrien prendre per a resoldre-les. A continuació, després de realitzar una anàlisi de dades, es crearan unes regles d'organització física del magatzem. Després, es proposarà un canvi del sistema d'identificació del material en el magatzem per a assegurar el bon seguiment del material a millor preu. En fi, es desenvoluparà d'una banda la lògica de funcionament d'una aplicació de gestió de magatzem, i d'altra banda la seva ergonomia per a assegurar un ús senzill.

Published
2019

20. A primary pancreatic carcinoid tumour with unusual clinical complaints: A case report

Author

Pozzo Alessandro, Cogliandolo Andrea, Saint-Marc Olivier, and Pidoto Rocco

Subjects
Carcinoid, Pancreas, Surgery, RD1-811, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Unless metastatic or compressing the pancreatic duct, carcinoid of the pancreas are asymptomatic showing normal levels of serotonine and its metabolites in plasma and urine, thus resulting in delayed diagnosis and a consequent poor prognosis. However, if resection is timely accomplished, no local recurrence might be encountered and a normal survival might be expected in the absence of metastatic disease. Case Presentation The reported case of pancreatic carcinoid tumour in a 62-year-old woman reporting only atypical symptoms consisting of intermittent epigastric pain and nausea. Urinary 5-hydroxyindolacetic acid levels were within normal limits and only a slight elevation of serum serotonine level was detected on admission. After tumour localisation with endoscopic ultrasonography, left splenopancreasectomy with splenic, celiac and hepatic lymphadenectomy was carried out. Conclusion The role of endoscopic ultrasonography in early detection and precise localisation of pancreatic carcinoids, as well as the role of somatostatin-receptor scintigraphy with 111Indium labelled pentreotide in excluding distant metastases, are confirmed. The radical resection with lymphadenectomy is recommended in order to have a precise histological examination and detect occult lymph node metastases.

Published
2004
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22. Laparoscopic intraoperative cholangiography for common bile duct lithiasis associated to calculous cholecystitis

Author

Fama, Fausto, marco cicciu, Cervino, Gabriele, Ferrara, Christian, Giacobbe, Giuseppa, Fiumano, Martina, Bramanti, Ennio, Lo Giudice, Giuseppe, Lauritano, Floriana, Piquard, Arnaud, Saint-Marc, Olivier, and Gioffre-Florio, Maria

Subjects
Choledocholithiasis, calculous cholecystitis, laparoscopy, choledochotomy, transcystic approach, short-stay hospitalisation, Choledocholithiasis, calculous cholecystitis, choledochotomy, transcystic approach, short-stay hospitalisation, laparoscopy
Published
2017

23. Pattern of nodal involvement in papillary thyroid cancer: a challenge of quantitative analysis

Author

Fama, Fausto, marco cicciu, Lo Giudice, Giuseppe, Sindoni, Alessandro, Palella, Jessica, Piquard, Arnaud, Saint-Marc, Olivier, Benvenga, Salvatore, Bramanti, Ennio, Cervino, Gabriele, and Florio, Maria Gioffre

Subjects
Adult, Male, Adolescent, Papillary thyroid cancer, Young Adult, Humans, Thyroid Neoplasms, Aged, Retrospective Studies, Aged, 80 and over, quantitative analysis, Carcinoma, Middle Aged, Carcinoma, Papillary, Thyroid Cancer, Papillary, Lymphatic Metastasis, Neck Dissection, Female, Original Article, Papillary thyroid cancer, lymph node metastases, cervical dissection, quantitative analysis, France, Lymph Nodes, Neck, lymph node metastases, cervical dissection, Follow-Up Studies
Abstract

Introduction: Backgrounds of this study were to examine and analyse the relationship among the number of lymph nodes with metastases harvested in central and lateral compartments, the characteristics of tumours and patients, and the recurrences rate. Methods: A retrospective review of 118 patients treated for a papillary thyroid cancer and underwent to neck dissection, including in all cases both central and lateral compartment, was realised. A quantitative analysis, on this homogeneous cohort of patients, was performed to hypothesize the minimum number of cervical lymph nodes to be necessarily excised in order to obtain an adequate management of these patients. Results: The mean follow-up time was 75.9 months. Five-year overall survival was 96.6%. The correlation among the metastatic lymph node number of the ipsilateral central compartment, isolated or pooled with those of the ipsilateral lateral compartment, age of patient and tumour size revealed a statistical significance (P=0.01); both parameters, tumour size and age, may be considered as dependent predictor variables. Conclusion: We suppose, notwithstanding the limited number of patients, that the number of lymph nodes harvested to achieve an optimal cervical dissection may be superior to 8 and 11 in central and lateral compartments, and 6 and 10 in contralateral ones, respectively. Moreover we recommend the bilateral dissection of central nodes compartment in presence of tumour localised in the isthmus.

Published
2015

25. A PRIMARY PANCREATIC CARCINOID TUMOUR WITH UNUSUAL CLINICAL COMPLAINTS: A CASE REPORT

Author

Saint-Marc, Olivier, Cogliandolo, Andrea, Pozzo, Alessandro, and Pidoto, Rocco Roberto

Subjects
lcsh:Surgery, Case Report, lcsh:RD1-811, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Carcinoid, Pancreas, lcsh:RC254-282
Abstract

Background Unless metastatic or compressing the pancreatic duct, carcinoid of the pancreas are asymptomatic showing normal levels of serotonine and its metabolites in plasma and urine, thus resulting in delayed diagnosis and a consequent poor prognosis. However, if resection is timely accomplished, no local recurrence might be encountered and a normal survival might be expected in the absence of metastatic disease. Case Presentation The reported case of pancreatic carcinoid tumour in a 62-year-old woman reporting only atypical symptoms consisting of intermittent epigastric pain and nausea. Urinary 5-hydroxyindolacetic acid levels were within normal limits and only a slight elevation of serum serotonine level was detected on admission. After tumour localisation with endoscopic ultrasonography, left splenopancreasectomy with splenic, celiac and hepatic lymphadenectomy was carried out. Conclusion The role of endoscopic ultrasonography in early detection and precise localisation of pancreatic carcinoids, as well as the role of somatostatin-receptor scintigraphy with 111Indium labelled pentreotide in excluding distant metastases, are confirmed. The radical resection with lymphadenectomy is recommended in order to have a precise histological examination and detect occult lymph node metastases.

Published
2004

26. Parathyroid Autotransplantation During Thyroid Surgery: A Novel Technique Using a Cell Culture Nutrient Solution

Author

Olivier Saint-Marc, Arnaud Piquard, Fausto Famà, Antonio Cascio, Marco Cicciù, Francesca Polito, Alessandro Sindoni, Maria Gioffrè-Florio, Famà, Fausto, Cicciù, Marco, Polito, Francesca, Cascio, Antonio, Gioffré-Florio, Maria, Piquard, Arnaud, Saint-Marc, Olivier, and Sindoni, Alessandro

Subjects
Adult, Male, medicine.medical_specialty, Hypoparathyroidism, medicine.medical_treatment, Parathyroid Gland, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Retrospective Studie, medicine, Parathyroid Gland, Total Thyroidectomy, Hypoparathyroidism, Serum Calcium Level, Sternocleidomastoid Muscle, Total Thyroidectomy, Hypocalcemia, business.industry, Thyroid disease, Serum Calcium Level, Thyroid, Thyroidectomy, Middle Aged, medicine.disease, Autotransplantation, Neck Muscle, Culture Media, Surgery, Sternocleidomastoid Muscle, Transplantation, Autologou, Transplantation, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, Parathyroid gland, Postoperative Complication, business, Surgical incision, Human
Abstract

Introduction: Parathyroid autotransplantation is an easy procedure with a low complication rate. We adopted the transplantation into the sternocleidomastoid muscle, which allows an easier and time-saving surgical procedure using the same surgical incision. Methods: In this study, we retrospectively reviewed the records of 396 consecutive patients, who underwent total thyroidectomy for benign thyroid disease. In all cases in which a parathyroid was damaged or inadvertently removed, the gland was transplanted; before the autotransplantation, the parathyroid tissue was put in a cell culture nutrient solution for 5 min, afterward fragmented, and then was transplanted in the sternocleidomastoid muscle. To demonstrate a beneficial effect of the cell nutrient solution step, we compared data of transplanted patients with a control group of cases (n = 190) undergoing a standard immediate autotransplantation. Results: We divided patients in two main groups: group A (n = 160) including subjects that underwent one or more parathyroid gland autotransplantation using the cell nutrient solution, and group B (n = 236) concerning those who were not transplanted. Among patients, 62 hypocalcemias occurred, 40 in the group A and 22 in the group B (P

Published
2016
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27. Use and outcome of minimally invasive pancreatic surgery in the European E-MIPS registry.

Author

van der Heijde N, Vissers FL, Manzoni A, Zimmitti G, Balsells J, Berrevoet F, Bjornsson B, van den Boezem P, Boggi U, Bratlie SO, Burdio F, Coratti A, D'Hondt M, Del Pozo CD, Dokmak S, Fara R, Can MF, Festen S, Forgione A, Fristrup C, Gaujoux S, Groot Koerkamp B, Hackert T, Khatkov IE, Keck T, Seppänen H, Lips D, Luyer M, Pittau G, Maglione M, Molenaar IQ, Pessaux P, Roeyen G, Saint-Marc O, Cabus SS, van Santvoort H, van der Schelling G, Serradilla-Martin M, Souche FR, Suarez Muñoz MÁ, Marino MV, Besselink MG, and Abu Hilal M

Subjects
Humans, Pancreas surgery, Pancreatectomy adverse effects, Pancreaticoduodenectomy adverse effects, Minimally Invasive Surgical Procedures, Registries, Postoperative Complications etiology, Treatment Outcome, Pancreatic Neoplasms surgery, Robotic Surgical Procedures adverse effects, Laparoscopy adverse effects
Abstract

Background: The European registry for minimally invasive pancreatic surgery (E-MIPS) collects data on laparoscopic and robotic MIPS in low- and high-volume centers across Europe., Methods: Analysis of the first year (2019) of the E-MIPS registry, including minimally invasive distal pancreatectomy (MIDP) and minimally invasive pancreatoduodenectomy (MIPD). Primary outcome was 90-day mortality., Results: Overall, 959 patients from 54 centers in 15 countries were included, 558 patients underwent MIDP and 401 patients MIPD. Median volume of MIDP was 10 (7-20) and 9 (2-20) for MIPD. Median use of MIDP was 56.0% (IQR 39.0-77.3%) and median use of MIPD 27.7% (IQR 9.7-45.3%). MIDP was mostly performed laparoscopic (401/558, 71.9%) and MIPD mostly robotic (234/401, 58.3%). MIPD was performed in 50/54 (89.3%) centers, of which 15/50 (30.0%) performed ≥20 MIPD annually. This was 30/54 (55.6%) centers and 13/30 (43%) centers for MIPD respectively. Conversion rate was 10.9% for MIDP and 8.4% for MIPD. Overall 90 day mortality was 1.1% (n = 6) for MIDP and 3.7% (n = 15) for MIPD., Conclusion: Within the E-MIPS registry, MIDP is performed in about half of all patients, mostly using laparoscopy. MIPD is performed in about a quarter of patients, slightly more often using the robotic approach. A minority of centers met the Miami guideline volume criteria for MIPD., (Copyright © 2022. Published by Elsevier Ltd.)

Published
2023
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28. Minimally invasive versus open distal pancreatectomy for pancreatic ductal adenocarcinoma (DIPLOMA): study protocol for a randomized controlled trial.

Author

van Hilst J, Korrel M, Lof S, de Rooij T, Vissers F, Al-Sarireh B, Alseidi A, Bateman AC, Björnsson B, Boggi U, Bratlie SO, Busch O, Butturini G, Casadei R, Dijk F, Dokmak S, Edwin B, van Eijck C, Esposito A, Fabre JM, Falconi M, Ferrari G, Fuks D, Groot Koerkamp B, Hackert T, Keck T, Khatkov I, de Kleine R, Kokkola A, Kooby DA, Lips D, Luyer M, Marudanayagam R, Menon K, Molenaar Q, de Pastena M, Pietrabissa A, Rajak R, Rosso E, Sanchez Velazquez P, Saint Marc O, Shah M, Soonawalla Z, Tomazic A, Verbeke C, Verheij J, White S, Wilmink HW, Zerbi A, Dijkgraaf MG, Besselink MG, and Abu Hilal M

Subjects
Humans, Pancreatectomy adverse effects, Postoperative Complications, Quality of Life, Randomized Controlled Trials as Topic, Retrospective Studies, Treatment Outcome, Carcinoma, Pancreatic Ductal surgery, Laparoscopy, Pancreatic Neoplasms surgery
Abstract

Background: Recently, the first randomized trials comparing minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) for non-malignant and malignant disease showed a 2-day reduction in time to functional recovery after MIDP. However, for pancreatic ductal adenocarcinoma (PDAC), concerns have been raised regarding the oncologic safety (i.e., radical resection, lymph node retrieval, and survival) of MIDP, as compared to ODP. Therefore, a randomized controlled trial comparing MIDP and ODP in PDAC regarding oncological safety is warranted. We hypothesize that the microscopically radical resection (R0) rate is non-inferior for MIDP, as compared to ODP., Methods/design: DIPLOMA is an international randomized controlled, patient- and pathologist-blinded, non-inferiority trial performed in 38 pancreatic centers in Europe and the USA. A total of 258 patients with an indication for elective distal pancreatectomy with splenectomy because of proven or highly suspected PDAC of the pancreatic body or tail will be randomly allocated to MIDP (laparoscopic or robot-assisted) or ODP in a 1:1 ratio. The primary outcome is the microscopically radical resection margin (R0, distance tumor to pancreatic transection and posterior margin ≥ 1 mm), which is assessed using a standardized histopathology assessment protocol. The sample size is calculated with the following assumptions: 5% one-sided significance level (α), 80% power (1-β), expected R0 rate in the open group of 58%, expected R0 resection rate in the minimally invasive group of 67%, and a non-inferiority margin of 7%. Secondary outcomes include time to functional recovery, operative outcomes (e.g., blood loss, operative time, and conversion to open surgery), other histopathology findings (e.g., lymph node retrieval, perineural- and lymphovascular invasion), postoperative outcomes (e.g., clinically relevant complications, hospital stay, and administration of adjuvant treatment), time and site of disease recurrence, survival, quality of life, and costs. Follow-up will be performed at the outpatient clinic after 6, 12, 18, 24, and 36 months postoperatively., Discussion: The DIPLOMA trial is designed to investigate the non-inferiority of MIDP versus ODP regarding the microscopically radical resection rate of PDAC in an international setting., Trial Registration: ISRCTN registry ISRCTN44897265 . Prospectively registered on 16 April 2018., (© 2021. The Author(s).)

Published
2021
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29. Minimally invasive experience for the treatment of gastrointestinal stromal tumours.

Author

Famà F, Scibilia G, Lo Presti D, Palella J, Saint-Marc O, Piquard A, and Gioffrè-Florio M

Subjects
Acute Disease, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage surgery, Humans, Prognosis, Gastrointestinal Neoplasms surgery, Gastrointestinal Stromal Tumors surgery, Minimally Invasive Surgical Procedures
Abstract

Gastrointestinal stromal tumours are rare mesenchymal neoplasms, accounting less than 3% of all the gastrointestinal tumours, that may arise in all portions of the gastrointestinal tract but more frequently they involve stomach and small bowel. Generally are asymptomatic or slight symptomatic, although they may also cause acute clinical conditions. Histologically are characterised by a meshwork of spindle-like cells mixed with fibro-hyaline stroma. The immunohistochemical assessment, marked for a strong immunopositivity for CD117 antibodies, allows the differential diagnosis with others muscular, nervous and fibroblastic tumours. Tumour size and mitotic rate are the most important prognostic indicators. Surgery represents the treatment for patients with primary non-metastatic disease, however a prolonged oncologic follow-up is always recommended. Minimally invasive technique is increasingly adopted and preferred for its low morbidity and shorter in-hospital stay, and more and more reports confirm its safety, efficacy and feasibility. We report a case series of three pauci-sympomatic patients, all hospitalised for severe anaemia related to a chronic gastrointestinal bleeding, successfully treated by laparoscopic approach for the removal of gastrointestinal stromal tumours, two located in the stomach and one in the jejunum.

Published
2015

30. A primary pancreatic carcinoid tumour with unusual clinical complaints: A case report.

Author

Saint-Marc O, Cogliandolo A, Pozzo A, and Pidoto RR

Abstract

Background: Unless metastatic or compressing the pancreatic duct, carcinoid of the pancreas are asymptomatic showing normal levels of serotonine and its metabolites in plasma and urine, thus resulting in delayed diagnosis and a consequent poor prognosis. However, if resection is timely accomplished, no local recurrence might be encountered and a normal survival might be expected in the absence of metastatic disease., Case Presentation: The reported case of pancreatic carcinoid tumour in a 62-year-old woman reporting only atypical symptoms consisting of intermittent epigastric pain and nausea. Urinary 5-hydroxyindolacetic acid levels were within normal limits and only a slight elevation of serum serotonine level was detected on admission. After tumour localisation with endoscopic ultrasonography, left splenopancreasectomy with splenic, celiac and hepatic lymphadenectomy was carried out., Conclusion: The role of endoscopic ultrasonography in early detection and precise localisation of pancreatic carcinoids, as well as the role of somatostatin-receptor scintigraphy with 111Indium labelled pentreotide in excluding distant metastases, are confirmed. The radical resection with lymphadenectomy is recommended in order to have a precise histological examination and detect occult lymph node metastases.

Published
2004
Full Text
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