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

Alessandro Giani; Tess van Ramshorst; European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS); Michele Mazzola; Claudio Bassi; Alessandro Esposito; Matteo de Pastena; Bjørn Edwin; Mushegh Sahakyan; Dyre Kleive; Asif Jah; Stijn van Laarhoven; Ugo Boggi; Emanuele Federico Kauffman; Riccardo Casadei; Claudio Ricci; Safi Dokmak; Fadhel Samir Ftériche; Steven A. White; Sivesh K. Kamarajah; Giovanni Butturini; Isabella Frigerio; Alessandro Zerbi; Giovanni Capretti; Elizabeth Pando; Robert P. Sutcliffe; Ravi Marudanayagam; Giuseppe Kito Fusai; Jean Michel Fabre; Bergthor Björnsson; Lea Timmermann; Zahir Soonawalla; Fernando Burdio; Tobias Keck; Thilo Hackert; Bas Groot Koerkamp; Mathieu d'Hondt; Andrea Coratti; Patrick Pessaux; Andrea Pietrabissa; Bilal Al-Sarireh; Marco V. Marino; Quintus Molenaar; Vincent Yip; Marc Besselink; Giovanni Ferrari; Mohammad Abu Hilal

doi:10.1093/bjs/znac204

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

Alessandro Giani, Tess van Ramshorst, European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Michele Mazzola, Claudio Bassi, Alessandro Esposito, Matteo de Pastena, Bjørn Edwin, Mushegh Sahakyan, Dyre Kleive, Asif Jah, Stijn van Laarhoven, Ugo Boggi, Emanuele Federico Kauffman, Riccardo Casadei, Claudio Ricci, Safi Dokmak, Fadhel Samir Ftériche, Steven A. White, Sivesh K. KamarajahGiovanni Butturini, Isabella Frigerio, Alessandro Zerbi, Giovanni Capretti, Elizabeth Pando, Robert P. Sutcliffe, Ravi Marudanayagam, Giuseppe Kito Fusai, Jean Michel Fabre, Bergthor Björnsson, Lea Timmermann, Zahir Soonawalla, Fernando Burdio, Tobias Keck, Thilo Hackert, Bas Groot Koerkamp, Mathieu d'Hondt, Andrea Coratti, Patrick Pessaux, Andrea Pietrabissa, Bilal Al-Sarireh, Marco V. Marino, Quintus Molenaar, Vincent Yip, Marc Besselink, Giovanni Ferrari, Mohammad Abu Hilal^*

^*Corresponding author for this work

Surgery

Research output: Contribution to journal › Article › Academic › peer-review

1 Citation (Scopus)

Abstract

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.

Original language	English
Pages (from-to)	1124-1130
Number of pages	7
Journal	The British journal of surgery
Volume	109
Issue number	11
DOIs	https://doi.org/10.1093/bjs/znac204
Publication status	Published - Nov 2022

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Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Giani, A., van Ramshorst, T., European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Mazzola, M., Bassi, C., Esposito, A., de Pastena, M., Edwin, B., Sahakyan, M., Kleive, D., Jah, A., van Laarhoven, S., Boggi, U., Kauffman, E. F., Casadei, R., Ricci, C., Dokmak, S., Ftériche, F. S., White, S. A., ... Hilal, M. A. (2022). Benchmarking of minimally invasive distal pancreatectomy with splenectomy: European multicentre study. The British journal of surgery, 109(11), 1124-1130. https://doi.org/10.1093/bjs/znac204

@article{d865b13279f548b9a808b8c395d8e157,

title = "Benchmarking of minimally invasive distal pancreatectomy with splenectomy: European multicentre study",

abstract = "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{\texttrademark}) 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.",

author = "Alessandro Giani and {van Ramshorst}, Tess and {European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)} and Michele Mazzola and Claudio Bassi and Alessandro Esposito and {de Pastena}, Matteo and Bj{\o}rn Edwin and Mushegh Sahakyan and Dyre Kleive and Asif Jah and {van Laarhoven}, Stijn and Ugo Boggi and Kauffman, {Emanuele Federico} and Riccardo Casadei and Claudio Ricci and Safi Dokmak and Ft{\'e}riche, {Fadhel Samir} and White, {Steven A.} and Kamarajah, {Sivesh K.} and Giovanni Butturini and Isabella Frigerio and Alessandro Zerbi and Giovanni Capretti and Elizabeth Pando and Sutcliffe, {Robert P.} and Ravi Marudanayagam and Fusai, {Giuseppe Kito} and Fabre, {Jean Michel} and Bergthor Bj{\"o}rnsson and Lea Timmermann and Zahir Soonawalla and Fernando Burdio and Tobias Keck and Thilo Hackert and {Groot Koerkamp}, Bas and Mathieu d'Hondt and Andrea Coratti and Patrick Pessaux and Andrea Pietrabissa and Bilal Al-Sarireh and Marino, {Marco V.} and Quintus Molenaar and Vincent Yip and Marc Besselink and Giovanni Ferrari and Hilal, {Mohammad Abu}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",

year = "2022",

month = nov,

doi = "10.1093/bjs/znac204",

language = "English",

volume = "109",

pages = "1124--1130",

journal = "British Journal of Surgery",

issn = "0007-1323",

publisher = "John Wiley & Sons Ltd.",

number = "11",

}

Giani, A, van Ramshorst, T, European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Mazzola, M, Bassi, C, Esposito, A, de Pastena, M, Edwin, B, Sahakyan, M, Kleive, D, Jah, A, van Laarhoven, S, Boggi, U, Kauffman, EF, Casadei, R, Ricci, C, Dokmak, S, Ftériche, FS, White, SA, Kamarajah, SK, Butturini, G, Frigerio, I, Zerbi, A, Capretti, G, Pando, E, Sutcliffe, RP, Marudanayagam, R, Fusai, GK, Fabre, JM, Björnsson, B, Timmermann, L, Soonawalla, Z, Burdio, F, Keck, T, Hackert, T, Groot Koerkamp, B, d'Hondt, M, Coratti, A, Pessaux, P, Pietrabissa, A, Al-Sarireh, B, Marino, MV, Molenaar, Q, Yip, V, Besselink, M, Ferrari, G & Hilal, MA 2022, 'Benchmarking of minimally invasive distal pancreatectomy with splenectomy: European multicentre study', The British journal of surgery, vol. 109, no. 11, pp. 1124-1130. https://doi.org/10.1093/bjs/znac204

Benchmarking of minimally invasive distal pancreatectomy with splenectomy : European multicentre study. / Giani, Alessandro; van Ramshorst, Tess; European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) et al.

In: The British journal of surgery, Vol. 109, No. 11, 11.2022, p. 1124-1130.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Benchmarking of minimally invasive distal pancreatectomy with splenectomy

T2 - European multicentre study

AU - Giani, Alessandro

AU - van Ramshorst, Tess

AU - European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)

AU - Mazzola, Michele

AU - Bassi, Claudio

AU - Esposito, Alessandro

AU - de Pastena, Matteo

AU - Edwin, Bjørn

AU - Sahakyan, Mushegh

AU - Kleive, Dyre

AU - Jah, Asif

AU - van Laarhoven, Stijn

AU - Boggi, Ugo

AU - Kauffman, Emanuele Federico

AU - Casadei, Riccardo

AU - Ricci, Claudio

AU - Dokmak, Safi

AU - Ftériche, Fadhel Samir

AU - White, Steven A.

AU - Kamarajah, Sivesh K.

AU - Butturini, Giovanni

AU - Frigerio, Isabella

AU - Zerbi, Alessandro

AU - Capretti, Giovanni

AU - Pando, Elizabeth

AU - Sutcliffe, Robert P.

AU - Marudanayagam, Ravi

AU - Fusai, Giuseppe Kito

AU - Fabre, Jean Michel

AU - Björnsson, Bergthor

AU - Timmermann, Lea

AU - Soonawalla, Zahir

AU - Burdio, Fernando

AU - Keck, Tobias

AU - Hackert, Thilo

AU - Groot Koerkamp, Bas

AU - d'Hondt, Mathieu

AU - Coratti, Andrea

AU - Pessaux, Patrick

AU - Pietrabissa, Andrea

AU - Al-Sarireh, Bilal

AU - Marino, Marco V.

AU - Molenaar, Quintus

AU - Yip, Vincent

AU - Besselink, Marc

AU - Ferrari, Giovanni

AU - Hilal, Mohammad Abu

PY - 2022/11

Y1 - 2022/11

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85140144605&partnerID=8YFLogxK

U2 - 10.1093/bjs/znac204

DO - 10.1093/bjs/znac204

M3 - Article

C2 - 35834788

AN - SCOPUS:85140144605

VL - 109

SP - 1124

EP - 1130

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

IS - 11

ER -

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

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