Defining Benchmark Outcomes for Pancreatoduodenectomy With Portomesenteric Venous Resection.
Journal article

Defining Benchmark Outcomes for Pancreatoduodenectomy With Portomesenteric Venous Resection.

  • Raptis DA Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK.
  • Sánchez-Velázquez P Department of Surgery, University Hospital del Mar, Barcelona, Spain.
  • Machairas N Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK.
  • Sauvanet A Department of Surgery, Hôpital Beaujon, Clichy, France.
  • Rueda de Leon A Department of Pancreatic Surgery, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico.
  • Oba A Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Colorado, CO.
  • Groot Koerkamp B Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Lovasik B Department of Surgery, Emory Saint Joseph's Hospital, Emory University, Atlanta, GA.
  • Chan C Department of Pancreatic Surgery, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico.
  • Yeo CJ Department of Surgery, Thomas Jefferson University, Philadelphia, PA.
  • Bassi C Department of Surgery, University Hospital of Verona, "Pancreas Institute," Verona, Italy.
  • Ferrone CR Department of Surgery, Massachusetts General Hospital, Boston, MA.
  • Kooby D Department of Surgery, Emory Saint Joseph's Hospital, Emory University, Atlanta, GA.
  • Moskal D Department of Surgery, Thomas Jefferson University, Philadelphia, PA.
  • Tamburrino D Department of Surgery, San Raffaele Hospital IRCCS, Vita-Salute University, Milano, Italy.
  • Yoon DS Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Barroso E Department of Surgery, Curry Cabral Hospital, CHLC, Lisbon, Portugal.
  • de Santibañes E Department of Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • Kauffmann EF Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
  • Vigia E Department of Surgery, Curry Cabral Hospital, CHLC, Lisbon, Portugal.
  • Robin F Department of HPB and Digestive Surgery, Rennes University Hospital, Rennes, France.
  • Casciani F Department of Surgery, University Hospital of Verona, "Pancreas Institute," Verona, Italy.
  • Burdío F Department of Surgery, University Hospital del Mar, Barcelona, Spain.
  • Belfiori G Department of Surgery, San Raffaele Hospital IRCCS, Vita-Salute University, Milano, Italy.
  • Malleo G Department of Surgery, University Hospital of Verona, "Pancreas Institute," Verona, Italy.
  • Lavu H Department of Surgery, Thomas Jefferson University, Philadelphia, PA.
  • Hartog H Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Hwang HK Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Han HS Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
  • Poves I Department of Surgery, University Hospital del Mar, Barcelona, Spain.
  • Rosado ID Department of Pancreatic Surgery, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico.
  • Park JS Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Lillemoe KD Department of Surgery, Massachusetts General Hospital, Boston, MA.
  • Roberts KJ Department of HPB Surgery and Liver Transplant, Queen Elizabeth Hospital, Birmingham, UK.
  • Sulpice L Department of HPB and Digestive Surgery, Rennes University Hospital, Rennes, France.
  • Besselink MG Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Abuawwad M Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Del Chiaro M Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Colorado, CO.
  • de Santibañes M Department of Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • Falconi M Department of Surgery, San Raffaele Hospital IRCCS, Vita-Salute University, Milano, Italy.
  • DʼSilva M Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
  • Silva M Department of HPB Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Abu Hilal M Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Qadan M Department of Surgery, Massachusetts General Hospital, Boston, MA.
  • Sell NM Department of Surgery, Massachusetts General Hospital, Boston, MA.
  • Beghdadi N Department of Surgery, Hôpital Beaujon, Clichy, France.
  • Napoli N Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
  • Busch ORC Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Mazza O Department of Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • Muiesan P Department of HPB Surgery and Liver Transplant, Queen Elizabeth Hospital, Birmingham, UK.
  • Müller PC Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
  • Ravikumar R Department of HPB Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Schulick R Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Colorado, CO.
  • Powell-Brett S Department of HPB Surgery and Liver Transplant, Queen Elizabeth Hospital, Birmingham, UK.
  • Abbas SH Department of HPB Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Mackay TM Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Stoop TF Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Gallagher TK Department of HPB Surgery, St. Vincent's University Hospital, Dublin, Ireland.
  • Boggi U Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
  • van Eijck C Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Clavien PA Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
  • Conlon KCP Department of HPB Surgery, St. Vincent's University Hospital, Dublin, Ireland.
  • Fusai GK Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK.
Show more…
  • 2020-09-05
Published in:
  • Annals of surgery. - 2020
English OBJECTIVE
The aim of this study was to establish clinically relevant outcome benchmark values using criteria for pancreatoduodenectomy (PD) with portomesenteric venous resection (PVR) from a low-risk cohort managed in high-volume centers.


SUMMARY BACKGROUND DATA
PD with PVR is regarded as the standard of care in patients with cancer involvement of the portomesenteric venous axis. There are, however, no benchmark outcome indicators for this population which hampers comparisons of patients undergoing PD with and without PVR resection.


METHODS
This multicenter study analyzed patients undergoing PD with any type of PVR in 23 high-volume centers from 2009 to 2018. Nineteen outcome benchmarks were established in low-risk patients, defined as the 75th percentile of the median outcome values of the centers (NCT04053998).


RESULTS
Out of 1462 patients with PD and PVR, 840 (58%) formed the benchmark cohort, with a mean age was 64 (SD11) years, 413 (49%) were females. Benchmark cutoffs, among others, were calculated as follows: Clinically relevant pancreatic fistula rate (International Study Group of Pancreatic Surgery): ≤14%; in-hospital mortality rate: ≤4%; major complication rate Grade≥3 and the CCI up to 6 months postoperatively: ≤36% and ≤26, respectively; portal vein thrombosis rate: ≤14% and 5-year survival for patients with pancreatic ductal adenocarcinoma: ≥9%.


CONCLUSION
These novel benchmark cutoffs targeting surgical performance, morbidity, mortality, and oncological parameters show relatively inferior results in patients undergoing vascular resection because of involvement of the portomesenteric venous axis. These benchmark values however can be used to conclusively assess the results of different centers or surgeons operating on this high-risk group.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/168889
Statistics

Document views: 9 File downloads: