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

Research output: Contribution to journalArticleAcademicpeer-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 languageEnglish
Pages (from-to)1124-1130
Number of pages7
JournalThe British journal of surgery
Volume109
Issue number11
DOIs
Publication statusPublished - Nov 2022

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