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Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods

Lookup NU author(s): Steven White

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. BACKGROUND: Benchmarking is an important tool for quality comparison and improvement. However, no benchmark values are available for minimally invasive spleen-preserving distal pancreatectomy, either laparoscopically or robotically assisted. The aim of this study was to establish benchmarks for these techniques using two different methods. METHODS: Data from patients undergoing laparoscopically or robotically assisted spleen-preserving distal pancreatectomy were extracted from a multicentre database (2006-2019). Benchmarks for 10 outcomes were calculated using the Achievable Benchmark of Care (ABC) and best-patient-in-best-centre methods. RESULTS: Overall, 951 laparoscopically assisted (77.3 per cent) and 279 robotically assisted (22.7 per cent) procedures were included. Using the ABC method, the benchmarks for laparoscopically assisted and robotically assisted spleen-preserving distal pancreatectomy respectively were: 150 and 207 min for duration of operation, 55 and 100 ml for blood loss, 3.5 and 1.7 per cent for conversion, 0 and 1.7 per cent for failure to preserve the spleen, 27.3 and 34.0 per cent for overall morbidity, 5.1 and 3.3 per cent for major morbidity, 3.6 and 7.1 per cent for pancreatic fistula grade B/C, 5 and 6 days for duration of hospital stay, 2.9 and 5.4 per cent for readmissions, and 0 and 0 per cent for 90-day mortality. Best-patient-in-best-centre methodology revealed milder benchmark cut-offs for laparoscopically and robotically assisted procedures, with operating times of 254 and 262.5 min, blood loss of 150 and 195 ml, conversion rates of 5.8 and 8.2 per cent, rates of failure to salvage spleen of 29.9 and 27.3 per cent, overall morbidity rates of 62.7 and 55.7 per cent, major morbidity rates of 20.4 and 14 per cent, POPF B/C rates of 23.8 and 24.2 per cent, duration of hospital stay of 8 and 8 days, readmission rates of 20 and 15.1 per cent, and 90-day mortality rates of 0 and 0 per cent respectively. CONCLUSION: Two benchmark methods for minimally invasive distal pancreatectomy produced different values, and should be interpreted and applied differently.


Publication metadata

Author(s): van Ramshorst TME, Giani A, Mazzola M, Dokmak S, Fteriche FS, Esposito A, de Pastena M, Lof S, Edwin B, Sahakyan M, Boggi U, Kauffman EF, Fabre JM, Souche RF, Zerbi A, Butturini G, Molenaar Q, Al-Sarireh B, Marino MV, Keck T, White SA, Casadei R, Burdio F, Bjornsson B, Soonawalla Z, Koerkamp BG, Fusai GK, Pessaux P, Jah A, Pietrabissa A, Hackert T, D'Hondt M, Pando E, Besselink MG, Ferrari G, Hilal MA

Publication type: Article

Publication status: Published

Journal:

Year: 2023

Volume: 110

Issue: 1

Pages: 76-83

Print publication date: 01/01/2023

Online publication date: 02/11/2022

Acceptance date: 30/09/2022

Date deposited: 11/01/2023

ISSN (print): 0007-1323

ISSN (electronic): 1365-2168

Publisher: Oxford University Press

URL: https://doi.org/10.1093/bjs/znac352

DOI: 10.1093/bjs/znac352

PubMed id: 36322465


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