Benchmarking of minimally invasive distal pancreatectomy with splenectomy: European multicentre studyVerona Univ Hosp, Italy.
Verona Univ Hosp, Italy.
Univ Oslo, Norway; Univ Oslo, Norway; Univ Oslo, Norway.
Univ Oslo, Norway; Univ Oslo, Norway; Univ Oslo, Norway.
Univ Oslo, Norway; Univ Oslo, Norway; Univ Oslo, Norway.
Cambridge Univ Hosp NHS Fdn Trust, England.
Cambridge Univ Hosp NHS Fdn Trust, England.
Univ Hosp Pisa, Italy.
Univ Hosp Pisa, Italy.
St Orsola Malpighi Hosp, Italy.
St Orsola Malpighi Hosp, Italy.
Beaujon Hosp, France.
Beaujon Hosp, France.
Freeman Hosp Newcastle upon Tyne, England.
Freeman Hosp Newcastle upon Tyne, England.
Pederzoli Hosp, Italy.
Pederzoli Hosp, Italy.
Humanitas Univ, Italy; IRCCS Humanitas Res Hosp, Italy.
Humanitas Univ, Italy; IRCCS Humanitas Res Hosp, Italy.
Vall dHebron Univ Hosp, Spain.
Univ Hosp Birmingham NHS Fdn Trust, England.
Univ Hosp Birmingham NHS Fdn Trust, England.
Royal Free London, England.
St Eloi Hosp, France.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Charite, Germany.
Oxford Univ Hosp, England.
Univ Hosp del Mar, Spain.
Univ Med Ctr Schleswig Holstein, Germany.
Heidelberg Univ Hosp, Germany.
Erasmus MC, Netherlands.
Groeninge Hosp, Belgium.
Careggi Univ Hosp, Italy.
Inst Hosp Univ Strasbourg, France.
Fdn IRCCS Policlin San Matteo, Italy.
Morriston Hosp, Wales.
Osped Riuniti Villa Sofia Cervello, Italy; Ist Villa Salus, Italy.
Univ Med Ctr Utrecht, Netherlands.
Barts Hlth NHS Trust, England.
Univ Amsterdam, Netherlands.
ASST Grande Osped Metropolitano Niguarda, Italy.
Ist Osped Fdn Poliambulanza, Italy.
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2022 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 109, no 11, p. 1124-1130Article in journal (Refereed) Published
Abstract [en]
This study aimed to assess best achievable outcomes in minimally invasive distal pancreatectomy with splenectomy, applying the Achievable Benchmark of Care method. This method of assessing outcomes should positively encourage comparisons, allowing single surgeons or entire units to anonymously and individually recognize what works well and where there might be room for improvement. 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 (TM)) 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/m(2) (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.
Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2022. Vol. 109, no 11, p. 1124-1130
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-187384DOI: 10.1093/bjs/znac204ISI: 000824962200001PubMedID: 35834788OAI: oai:DiVA.org:liu-187384DiVA, id: diva2:1689034
2022-08-222022-08-222023-02-16Bibliographically approved