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Article Dans Une Revue Annals of Surgery Année : 2023

Defining Benchmark Outcomes for Distal Pancreatectomy: Results of a French Multicentric Study.

1 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
2 Hôpital Cochin [AP-HP]
3 Hôpital Beaujon [AP-HP]
4 IVH - Institut de Recherche sur les Maladies Virales et Hépatiques
5 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
6 CHU Bordeaux
7 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
8 AMU SMPM MED - Aix-Marseille Université - École de médecine
9 IPC - Institut Paoli-Calmettes
10 CRCM - Centre de Recherche en Cancérologie de Marseille
11 Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes]
12 OSS - Oncogenesis, Stress, Signaling
13 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
14 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
15 IRCM - U1194 Inserm - UM - Institut de Recherche en Cancérologie de Montpellier
16 UM - Université de Montpellier
17 Hôpital Edouard Herriot [CHU - HCL]
18 APHM - Assistance Publique - Hôpitaux de Marseille
19 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
20 M2iSH - Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte
21 CIC 1405 - Centre d'Investigation Clinique [CHU Clermont-Ferrand]
22 CHU Pitié-Salpêtrière [AP-HP]
23 IMM - Institut mutualiste Monsouris
24 Service de Chirurgie Digestive [CHU Rouen]
25 CHU Trousseau [Tours]
26 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
27 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
28 CHU Nice - Centre Hospitalier Universitaire de Nice
29 Chirurgie digestive [CHU Amiens]
30 SSPC - Simplification des soins chez les patients complexes - UR UPJV 7518
Ugo Marchese
Alain Sauvanet
Safi Dokmak
David Fuks
  • Fonction : Auteur
  • PersonId : 1104182
Christophe Laurent
Ahmet Ayav
  • Fonction : Auteur
  • PersonId : 762396
  • IdRef : 09518399X
Julie Perinel
Stylianos Tzedakis
Sébastien Gaujoux
Louise Barbier
Antonio Iannelli
  • Fonction : Auteur
  • PersonId : 1098777

Résumé

Objective: Defining robust and standardized outcome references for distal pancreatectomy (DP) by using Benchmark analysis. Background: Outcomes after DP are recorded in medium or small-sized studies without standardized analysis. Therefore, the best results remain uncertain. Methods: This multicenter study included all patients undergoing DP for resectable benign or malignant tumors in 21 French expert centers in pancreas surgery from 2014 to 2018. A low-risk cohort defined by no significant comorbidities was analyzed to establish 18 outcome benchmarks for DP. These values were tested in high risk, minimally invasive and benign tumor cohorts. Results: A total of 1188 patients were identified and 749 low-risk patients were screened to establish Benchmark cut-offs. Therefore, Benchmark rate for mini-invasive approach was ≥36.8%. Benchmark cut-offs for postoperative mortality, major morbidity grade ≥3a and clinically significant pancreatic fistula rates were 0%, ≤27%, and ≤28%, respectively. The benchmark rate for readmission was ≤16%. For patients with pancreatic adenocarcinoma, cut-offs were ≥75%, ≥69.5%, and ≥66% for free resection margins (R0), 1-year disease-free survival and 3-year overall survival, respectively. The rate of mini-invasive approach in high-risk cohort was lower than the Benchmark cut-off (34.1% vs ≥36.8%). All Benchmark cut-offs were respected for benign tumor group. The proportion of benchmark cases was correlated to outcomes of DP. Centers with a majority of low-risk patients had worse results than those operating complex cases. Conclusion: This large-scale study is the first benchmark analysis of DP outcomes and provides robust and standardized data. This may allow for comparisons between surgeons, centers, studies, and surgical techniques.
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Dates et versions

hal-03711172 , version 1 (21-02-2024)

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Thibault Durin, Ugo Marchese, Alain Sauvanet, Safi Dokmak, Zineb Cherkaoui, et al.. Defining Benchmark Outcomes for Distal Pancreatectomy: Results of a French Multicentric Study.. Annals of Surgery, 2023, 278 (1), pp.103-109. ⟨10.1097/SLA.0000000000005539⟩. ⟨hal-03711172⟩
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