• Lianne Scholten, Sjors Klompmaker, Jony Van Hilst, Mario M Annecchiarico, Gianpaolo Balzano, Riccardo Casadei, Jean-Michel Fabre, Massimo Falconi, Giovanni Ferrari, Mustafa Kerem, Igor E Khatkov, Carlo Lombardo, Alberto Manzoni, Michele Mazzola, Niccolò Napoli, Edoardo E Rosso, Pavel Tyutyunnik, Ulrich F Wellner, David Fuks, Fernando Burdio, Tobias Keck, HilalMohammed AbuMADepartment of Surgery, Fondazione Poliambulanza - Istituto Ospedaliero, Brescia, Italy.Department of Surgery, Southampton University Hospital NHS Foundation Trust, Southampton, UK., Marc G Besselink, Ugo Boggi, and European consortium on Minimally Invasive Pancreatic Surgery and the Scientific and Research Committee of the European-African Hepato-Pancreato-Biliary Association.
• Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
• Ann. Surg. 2023 Feb 1; 277 (2): 313320313-320.

ObjectiveTo assess postoperative 90-day outcomes after minimally invasive (laparoscopic/robot-assisted) total pancreatectomy (MITP) in selected patients versus open total pancreatectomy (OTP) among European centers.BackgroundMinimally invasive pancreatic surgery is becoming increasingly popular but data on MITP are scarce and multicenter studies comparing outcomes versus OTP are lacking. It therefore remains unclear if MITP is a valid alternative.MethodsMulticenter retrospective propensity-score matched study including consecutive adult patients undergoing MITP or OTP for all indications at 16 European centers in 7 countries (2008-2017). Patients after MITP were matched (1:1, caliper 0.02) to OTP controls. Missing data were imputed. The primary outcome was 90-day major morbidity (Clavien-Dindo ≥3a). Secondary outcomes included 90-day mortality, length of hospital stay, and survival.ResultsOf 361 patients (99MITP/262 OTP), 70 MITP procedures (50 laparoscopic, 15 robotic, 5 hybrid) could be matched to 70 OTP controls. After matching, MITP was associated with a lower rate of major morbidity (17% MITP vs. 31% OTP, P = 0.022). The 90-day mortality (1.4% MITP vs. 7.1% OTP, P = 0.209) and median hospital stay (17 [IQR 11-24] MITP vs. 12 [10-23] days OTP, P = 0.876) did not differ significantly. Among 81 patients with PDAC, overall survival was 3.7 (IQR 1.7-N/A) versus 0.9 (IQR 0.5-N/ A) years, for MITP versus OTP, which was nonsignificant after stratification by T-stage.ConclusionThis international propensity score matched study showed that MITP may be a valuable alternative to OTP in selected patients, given the associated lower rate of major morbidity.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

10 keywords...

hide…