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, Karin Johansen Department of Surgery in Linköping and Department of Biomedical and Clinical Sciences, Linköping University , Linköping , Sweden Search for other works by this author on: Oxford Academic Simone Augustinus Amsterdam UMC, location University of Amsterdam, Department of surgery, Amsterdam, the Netherlands, and Cancer Center Amsterdam , the Netherlands Search for other works by this author on: Oxford Academic Ulrich Wellner DGAV StuDoQ|Pancreas Registry and Clinic of Surgery , UKSH Campus Lübeck , Germany Search for other works by this author on: Oxford Academic Bodil Andersson Department of Clinical Sciences Lund, Surgery, Lund University, Skåne University Hospital , Lund , Sweden Search for other works by this author on: Oxford Academic Joal Beane Department of Surgery, The Ohio State University , Columbus, OH , USA Search for other works by this author on: Oxford Academic Bergthor Björnsson Department of Surgery in Linköping and Department of Biomedical and Clinical Sciences, Linköping University , Linköping , Sweden Search for other works by this author on: Oxford Academic Olivier Busch Amsterdam UMC, location University of Amsterdam, Department of surgery, Amsterdam, the Netherlands, and Cancer Center Amsterdam , the Netherlands Search for other works by this author on: Oxford Academic Catherine Davis Department of Surgery, Baylor University Medical Center , Dallas, Texas Search for other works by this author on: Oxford Academic Michael Ghadimi Department of General, Visceral, and Paediatric Surgery, University Medical Centre Göttingen , Göttingen Search for other works by this author on: Oxford Academic Elizabeth Gleeson Department of Surgery, University of North Carolina at Chapel Hill , North Carolina , USA Search for other works by this author on: Oxford Academic
, Nine de Graaf Amsterdam UMC, location University of Amsterdam, Department of surgery, Amsterdam, the Netherlands, and Cancer Center Amsterdam , the Netherlands Search for other works by this author on: Oxford Academic Bas Koerkamp Department of Surgery, Erasmus Medical Center , Rotterdam , the Netherlands Search for other works by this author on: Oxford Academic Henry Pitt Rutgers Cancer Institute of New Jersey , New Brunswick, New Jersey , the United States of America Search for other works by this author on: Oxford Academic Hjalmar van Santvoort Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht and St. Antonius Hospital Nieuwegein , the Netherlands Search for other works by this author on: Oxford Academic Bobby Tingstedt Department of Clinical Sciences Lund, Surgery, Lund University, Skåne University Hospital , Lund , Sweden Search for other works by this author on: Oxford Academic Waldemar Uhl Klinik für Allgemein- und Viszeralchirurgie, St. Josef-Hospital Bochum, Klinik der Ruhr-Universität , Bochum Search for other works by this author on: Oxford Academic Jens Werner Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Ludwig-Maximilians-Universität , München Search for other works by this author on: Oxford Academic Caroline Williamsson Department of Clinical Sciences Lund, Surgery, Lund University, Skåne University Hospital , Lund , Sweden Search for other works by this author on: Oxford Academic Marc Besselink Amsterdam UMC, location University of Amsterdam, Department of surgery, Amsterdam, the Netherlands, and Cancer Center Amsterdam , the Netherlands Search for other works by this author on: Oxford Academic Tobias Keck DGAV StuDoQ|Pancreas Registry and Clinic of Surgery , UKSH Campus Lübeck , Germany Search for other works by this author on: Oxford Academic
British Journal of Surgery, Volume 111, Issue Supplement_7, August 2024, znae175.002, https://doi.org/10.1093/bjs/znae175.002
Published:
02 August 2024
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Karin Johansen, Simone Augustinus, Ulrich Wellner, Bodil Andersson, Joal Beane, Bergthor Björnsson, Olivier Busch, Catherine Davis, Michael Ghadimi, Elizabeth Gleeson, Nine de Graaf, Bas Koerkamp, Henry Pitt, Hjalmar van Santvoort, Bobby Tingstedt, Waldemar Uhl, Jens Werner, Caroline Williamsson, Marc Besselink, Tobias Keck, 71342 - International differences in selection and outcome of minimally invasive and open distal pancreatectomy: a transatlantic analysis, British Journal of Surgery, Volume 111, Issue Supplement_7, August 2024, znae175.002, https://doi.org/10.1093/bjs/znae175.002
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Abstract
Introduction
The safety and efficacy of minimally invasive distal pancreatectomy (MIDP) has been confirmed within randomized trials. Information regarding differences in patient selection and outcomes of MIDP and open distal pancreatectomy (ODP) among countries is however lacking. This study compared MIDP and ODP in North America (NA), the Netherlands (NL), Germany (GER) and Sweden (SWE).
Method
Patients registered in the four pancreatic registries of the GAPASURG collaboration who underwent MIDP or ODP from 2014 to 2020 were included.
Result
Overall, 20 158 DPs were included; 7316 (36%) MIDP. Use of MIDP varied from 29% to 54% among registries, of which 13-35% were performed robotically (figure 1). Patients undergoing MIDP tended to be younger (GER and SWE), female (NA, GER), have higher body mass index (NA, NL, GER), lower comorbidity classification (NA, GER, SWE), lower performance status (GER), and lower rate of pancreatic ductal adenocarcinoma (all). Patients in the MIDP group had less vascular resections (all) and lower rates of severe complications and mortality (NA and GER). In the multivariable analysis, country was significantly associated with severe complications but not with 30-day mortality.
Discussion
Considerable disparities in the use and outcome of MIDP were shown among four transatlantic registries of pancreatic surgery. The differences in patient selection and outcomes imply that countries are in different stages of their learning curve.
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© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
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Topic:
- body mass index procedure
- surgical procedures, minimally invasive
- comorbidity
- germany
- karnofsky performance status
- netherlands
- safety
- mortality
- pancreas
- procedures on pancreas
- pancreatectomy, distal
- pancreatic ductal adenocarcinoma
- health disparity
- minimally invasive distal pancreatectomy
Issue Section:
Abstract > Upper GI
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