• Thibault Durin, Ugo Marchese, Alain Sauvanet, Safi Dokmak, Zineb Cherkaoui, David Fuks, Christophe Laurent, Marie André, Ahmet Ayav, Cloe Magallon, Olivier Turrini, Laurent Sulpice, Fabien Robin, Philippe Bachellier, Pietro Addeo, François-Régis Souche, Thomas Bardol, Julie Perinel, Mustapha Adham, Stylianos Tzedakis, David J Birnbaum, Olivier Facy, Johan Gagniere, Sébastien Gaujoux, Ecoline Tribillon, Edouard Roussel, Lilian Schwarz, Louise Barbier, Alexandre Doussot, Nicolas Regenet, Antonio Iannelli, Jean-Marc Regimbeau, Guillaume Piessen, Xavier Lenne, Stéphanie Truant, and Mehdi El Amrani.
• Department of Digestive Surgery and Transplantation, Lille University Hospital, Lille, France.
• Ann. Surg. 2023 Jul 1; 278 (1): 103109103-109.

ObjectiveDefining robust and standardized outcome references for distal pancreatectomy (DP) by using Benchmark analysis.BackgroundOutcomes after DP are recorded in medium or small-sized studies without standardized analysis. Therefore, the best results remain uncertain.MethodsThis multicenter study included all patients undergoing DP for resectable benign or malignant tumors in 21 French expert centers in pancreas surgery from 2014 to 2018. A low-risk cohort defined by no significant comorbidities was analyzed to establish 18 outcome benchmarks for DP. These values were tested in high risk, minimally invasive and benign tumor cohorts.ResultsA total of 1188 patients were identified and 749 low-risk patients were screened to establish Benchmark cut-offs. Therefore, Benchmark rate for mini-invasive approach was ≥36.8%. Benchmark cut-offs for postoperative mortality, major morbidity grade ≥3a and clinically significant pancreatic fistula rates were 0%, ≤27%, and ≤28%, respectively. The benchmark rate for readmission was ≤16%. For patients with pancreatic adenocarcinoma, cut-offs were ≥75%, ≥69.5%, and ≥66% for free resection margins (R0), 1-year disease-free survival and 3-year overall survival, respectively. The rate of mini-invasive approach in high-risk cohort was lower than the Benchmark cut-off (34.1% vs ≥36.8%). All Benchmark cut-offs were respected for benign tumor group. The proportion of benchmark cases was correlated to outcomes of DP. Centers with a majority of low-risk patients had worse results than those operating complex cases.ConclusionThis large-scale study is the first benchmark analysis of DP outcomes and provides robust and standardized data. This may allow for comparisons between surgeons, centers, studies, and surgical techniques.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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