Minimally invasive pancreatoduodenectomy

Michael L Kendrick; Jony van Hilst; Ugo Boggi; Thijs de Rooij; R Matthew Walsh; Herbert J Zeh; Steven J Hughes; Yoshiharu Nakamura; Charles M Vollmer; David A Kooby; Horacio J Asbun; Minimally Invasive Pancreatic Resection Organizing Committee

doi:10.1016/j.hpb.2017.01.023

Minimally invasive pancreatoduodenectomy

HPB (Oxford). 2017 Mar;19(3):215-224. doi: 10.1016/j.hpb.2017.01.023.

Collaborators

Minimally Invasive Pancreatic Resection Organizing Committee:
Horacio J Asbun¹¹, Jeffrey Barkun¹², Marc Gh Besselink¹³, Ugo Boggi³, Kevin Cp Conlon¹⁴, Ho-Seong Han¹⁵, Paul D Hansen¹⁶, Michael L Kendrick¹⁷, David A Kooby⁹, Andre L Montagnini¹⁸, C Palanivelu¹⁹, Bård I Røsok²⁰, Shailesh V Shrikhande²¹, Go Wakabayashi²², Herbert Zeh⁵, Charles M Vollmer²³

Affiliations

¹ Mayo Clinic, Rochester, MN, USA. Electronic address: [email protected].
² Academic Medical Center, Amsterdam, The Netherlands.
³ University of Pisa, Pisa, Italy.
⁴ Cleveland Clinic, Cleveland, OH, USA.
⁵ University of Pittsburgh, Pittsburgh, PA, USA.
⁶ University of Florida, Gainesville, FL, USA.
⁷ Nippon Medical School, Tokyo, Japan.
⁸ University of Pennsylvania, Philadelphia, PA, USA.
⁹ Emory University, Atlanta, GA, USA.
¹⁰ Mayo Clinic, Jacksonville, FL, USA.
¹¹ Mayo Clinic Florida, Jacksonville, FL, USA.
¹² McGill University, Montreal, Quebec, Canada.
¹³ University of Amsterdam, Amsterdam, The Netherlands.
¹⁴ The University of Dublin, Trinity College, Dublin, Ireland.
¹⁵ Seoul National University Bundang Hospital, SeongNam si, South Korea.
¹⁶ Portland Providence Cancer Center, Portland, OR, USA.
¹⁷ The Mayo Clinic - Rochester, Rochester, MN, USA.
¹⁸ Universidade de Sao Paulo, Sao Paulo, Brazil.
¹⁹ GEM Hospital & Research Center, Coimbatore, Tamil Nadu, India.
²⁰ Oslo University Hospital, Oslo, Norway.
²¹ Tata Memorial Centre, Mumbai, India.
²² Ageo Central General Hospital, Saitama, Japan.
²³ The University of Pennsylvania, Philadelphia, PA, USA.

PMID: 28317658
DOI: 10.1016/j.hpb.2017.01.023

Abstract

Background: Minimally invasive pancreatoduodenectomy (MIPD) is increasingly performed with several institutional series and comparative studies reported. The aim was to conduct an assessment of the best-evidence and expert opinion on the current status and future challenges of MIPD.

Methods: A systematic review of the literature was performed and best-evidence presented at a State-of-the-Art conference on Minimally Invasive Pancreatic Resection. Expert panel discussion and audience response activity was used to assess perceived value and future direction.

Results: From 582 studies, 26 comparative trials of MIPD and open pancreatoduodenectomy (OPD) were assessed for perioperative outcomes. There were no randomized controlled trials and all available comparative studies were determined of low quality. Several observational and case-matched studies demonstrate longer operative times, but less estimated blood loss and shorter length of hospital stay for MIPD. Registry-based studies demonstrate increased mortality rates after MIPD in low-volume centers. Oncologic assessment demonstrates comparable outcomes of MIPD. Expert opinion supports ongoing evaluation of MIPD.

Conclusion: MIPD appears to provide similar perioperative and oncologic outcomes in selected patients, when performed at experienced, high-volume centers. Its overall role in pancreatoduodenectomy needs to be better defined. Improved training opportunities, registry participation and prospective evaluation are needed.

Publication types

Review
Systematic Review

MeSH terms

Benchmarking
Congresses as Topic
Evidence-Based Medicine
Humans
Laparoscopy* / adverse effects
Pancreaticoduodenectomy / adverse effects
Pancreaticoduodenectomy / methods*
Postoperative Complications / etiology
Risk Factors
Robotic Surgical Procedures* / adverse effects
Treatment Outcome