Complexity and Experience Grading to Guide Patient Selection for Minimally Invasive Pancreatoduodenectomy: An International Study Group for Pancreatic Surgery (ISGPS) Consensus.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Barreto S George, Strobel Oliver, Salvia Roberto, Marchegiani Giovanni, Wolfgang Christopher L, Werner Jens, Ferrone Cristina R, Abu Hilal Mohammed, Boggi Ugo, Butturini Giovanni, Falconi Massimo, Fernandez-Del Castillo Carlos, Friess Helmut, Fusai Giuseppe K, Halloran Christopher M, Hogg Melissa, Jang Jin-Young, Kleeff Jorg, Lillemoe Keith D, Miao Yi, Nagakawa Yuichi, Nakamura Masafumi, Probst Pascal, Satoi Sohei, Siriwardena Ajith K, Vollmer Charles M, Zureikat Amer, Zyromski Nicholas J, Asbun Horacio J, Dervenis Christos, Neoptolemos John P, Büchler Markus W, Hackert Thilo, Besselink Marc G, Shrikhande Shailesh V, International Study Group for Pancreatic Surgery
Аннотация
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.