Complexity and Experience Grading to Guide Patient Selection for Minimally Invasive Pancreatoduodenectomy: An International Study Group for Pancreatic Surgery (ISGPS) Consensus
| Title: | Complexity and Experience Grading to Guide Patient Selection for Minimally Invasive Pancreatoduodenectomy: An International Study Group for Pancreatic Surgery (ISGPS) Consensus |
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| Authors: | Barreto, SG; Strobel, O; Salvia, R; Marchegiani, G; Wolfgang, CL; Werner, J; Ferrone, CR; Abu Hilal, M; Boggi, U; Butturini, G; Falconi, M; Fernandez-Del Castillo, C; Friess, H; Fusai, GK; Halloran, CM; Hogg, M; Jang, JY; Kleeff, J; Lillemoe, KD; Miao, Y; Nagakawa, Y; Nakamura, M; Probst, P; Satoi, S; Siriwardena, AK; Vollmer, CM; Zureikat, A; Zyromski, NJ; Asbun, HJ; Dervenis, C; Neoptolemos, JP; Büchler, MW; Hackert, T; Besselink, MG; Shrikhande, SV; Casciani, F |
| Publisher Information: | Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: | 2025 |
| Collection: | The University of Liverpool Repository |
| Description: | Objective: To develop a universally accepted complexity and experience grading system to guide the safe implementation of robotic and laparoscopic minimally invasive pancreatoduodenectomy (MIPD). Background: Despite the perceived advantages of MIPD, its global adoption has been slow due to the inherent complexity of the procedure and challenges to acquiring surgical experience. Its wider adoption must be undertaken with an emphasis on appropriate patient selection according to adequate surgeon and center experience. Methods: The International Study Group for Pancreatic Surgery (ISGPS) developed a complexity and experience grading system to guide patient selection for MIPD based on an evidence-based review and a series of discussions. Results: The ISGPS complexity and experience grading system for MIPD is subclassified into patient-related risk factors and provider experience-related variables. The patient-related risk factors include anatomic (main pancreatic and common bile duct diameters), tumor-specific (vascular contact), and conditional (obesity and previous complicated upper abdominal surgery/disease) factors, all incorporated in an A-B-C classification, graded as no, a single, and multiple risk factors. The surgeon and center experience-related variables include surgeon total MIPD experience (cutoffs 40 and 80) and center annual MIPD volume (cutoffs 10 and 30), all also incorporated in an A-B-C classification. Conclusions: This ISGPS complexity and experience grading system for robotic and laparoscopic MIPD may enable surgeons to optimally select patients after duly considering specific risk factors known to influence the complexity of the procedure. This grading system will likely allow for a thoughtful and stepwise implementation of MIPD and facilitate a fair comparison of outcomes between centers and countries. |
| Document Type: | article in journal/newspaper |
| File Description: | text |
| Language: | English |
| ISSN: | 0003-4932 |
| Relation: | https://livrepository.liverpool.ac.uk/3183075/1/complexity_and_experience_grading_to_guide_patient.985.pdf; Collapse authors list. Barreto, SG, Strobel, O, Salvia, R, Marchegiani, G, Wolfgang, CL, Werner, J, Ferrone, CR, Abu Hilal, M, Boggi, U, Butturini, G et al (show 26 more authors) , Falconi, M, Fernandez-Del Castillo, C, Friess, H, Fusai, GK, Halloran, CM orcid:0000-0002-5471-4178 , Hogg, M, Jang, JY, Kleeff, J, Lillemoe, KD, Miao, Y, Nagakawa, Y, Nakamura, M, Probst, P, Satoi, S, Siriwardena, AK, Vollmer, CM, Zureikat, A, Zyromski, NJ, Asbun, HJ, Dervenis, C, Neoptolemos, JP, Büchler, MW, Hackert, T, Besselink, MG, Shrikhande, SV and Casciani, F (2025) Complexity and Experience Grading to Guide Patient Selection for Minimally Invasive Pancreatoduodenectomy: An International Study Group for Pancreatic Surgery (ISGPS) Consensus Annals of Surgery, 281 (3). pp. 417-429. ISSN 0003-4932, 1528-1140 |
| DOI: | 10.1097/sla.0000000000006454 |
| Availability: | https://livrepository.liverpool.ac.uk/3183075/; https://doi.org/10.1097/sla.0000000000006454; https://livrepository.liverpool.ac.uk/3183075/1/complexity_and_experience_grading_to_guide_patient.985.pdf |
| Rights: | cc_by_4 |
| Accession Number: | edsbas.8B0AE5B9 |
| Database: | BASE |