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19 results on '"Fabre, Jean M."'

1. Endoscopic papillectomy for ampullary lesions of minor papilla

Author

Vu Trung, Kien, Heise, Christian, Abou-Ali, Einas, Auriemma, Francesco, Karam, Elias, van der Wiel, Sophia E., Bruno, Marco J., Caillol, Fabrice, Giovannini, Marc, Masaryk, Viliam, Will, Uwe, Anderloni, Andrea, Pérez-Cuadrado-Robles, Enrique, Dugic, Ana, Meier, Benjamin, Paik, Woo H., Petrone, Maria C., Wichmann, Dörte, Dinis-Ribeiro, Mario, Gonçalves, Tiago C., Wedi, Edris, Schmidt, Arthur, Gulla, Aiste, Hoffmeister, Albrecht, Rosendahl, Jonas, Ratone, Jean Philippe, Saadeh, Rita, Repici, Alessandro, Deprez, Pierre, Sauvanet, Alain, Souche, Francois R., Fabre, Jean M., Muehldorfer, Steffen, Caca, Karel, Löhr, Matthias, Michl, Patrick, Krug, Sebastian, Regner, Sara, Gaujoux, Sebastien, and Hollenbach, Marcus

Published
2024
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2. Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study

Author

Chen, Jeffrey W., van Ramshorst, Tess M. E., Lof, Sanne, Al-Sarireh, Bilal, Bjornsson, Bergthor, Boggi, Ugo, Burdio, Fernando, Butturini, Giovanni, Casadei, Riccardo, Coratti, Andrea, D’Hondt, Mathieu, Dokmak, Safi, Edwin, Bjørn, Esposito, Alessandro, Fabre, Jean M., Ferrari, Giovanni, Ftériche, Fadhel S., Fusai, Giuseppe K., Groot Koerkamp, Bas, Hackert, Thilo, Jah, Asif, Jang, Jin-Young, Kauffmann, Emanuele F., Keck, Tobias, Manzoni, Alberto, Marino, Marco V., Molenaar, Quintus, Pando, Elizabeth, Pessaux, Patrick, Pietrabissa, Andrea, Soonawalla, Zahir, Sutcliffe, Robert P., Timmermann, Lea, White, Steven, Yip, Vincent S., Zerbi, Alessandro, Abu Hilal, Mohammad, and Besselink, Marc G.

Published
2023
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3. ASO Visual Abstract: Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer—An International Retrospective Cohort Study

Author

Chen, Jeffrey W., van Ramshorst, Tess M. E., Lof, Sanne, Al-Sarireh, Bilal, Bjornsson, Bergthor, Boggi, Ugo, Burdio, Fernando, Butturini, Giovanni, Casadei, Riccardo, Coratti, Andrea, D’Hondt, Mathieu, Dokmak, Safi, Edwin, Bjørn, Esposito, Alessandro, Fabre, Jean M., Ferrari, Giovanni, Ftériche, Fadhel S., Fusai, Giuseppe K., Koerkamp, Bas Groot, Hackert, Thilo, Jah, Asif, Jang, Jin-Young, Kauffmann, Emanuele F., Keck, Tobias, Manzoni, Alberto, Marino, Marco V., Molenaar, Quintus, Rau, Elizabeth Pando, Pessaux, Patrick, Pietrabissa, Andrea, Soonawalla, Zahir, Sutcliffe, Robert P., Timmermann, Lea, White, Steven, Yip, Vincent S., Zerbi, Alessandro, Hilal, Mohammad Abu, and Besselink, Marc G.

Published
2023
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4. Endoscopic Papillectomy for Ampullary Lesions of minor papilla

Author

Trung, Kien Vu, primary, Heise, Christian, additional, Abou-Ali, Einas, additional, Auriemma, Francesco, additional, Karam, Elias, additional, van der Wiel, Sophia E., additional, Bruno, Marco J., additional, Caillol, Fabrice, additional, Giovannini, Marc, additional, Masaryk, Viliam, additional, Will, Uwe, additional, Anderloni, Andrea, additional, Pérez-Cuadrado-Robles, Enrique, additional, Dugic, Ana, additional, Meier, Benjamin, additional, Paik, Woo H., additional, Petrone, Maria C., additional, Wichmann, Dörte, additional, Dinis-Ribeiro, Mario, additional, Gonçalves, Tiago C., additional, Wedi, Edris, additional, Schmidt, Arthur, additional, Gulla, Aiste, additional, Hoffmeister, Albrecht, additional, Rosendahl, Jonas, additional, Ratone, Jean Philippe, additional, Saadeh, Rita, additional, Repici, Alessandro, additional, Deprez, Pierre, additional, Sauvanet, Alain, additional, Souche, Francois R., additional, Fabre, Jean M., additional, Muehldorfer, Steffen, additional, Caca, Karel, additional, Löhr, Matthias, additional, Michl, Patrick, additional, Krug, Sebastian, additional, Regner, Sara, additional, Gaujoux, Sebastien, additional, and Hollenbach, Marcus, additional

Published
2023
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5. Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study

Author

Chen, Jeffrey, van Ramshorst, Tess M. E., Lof, Sanne, Al-Sarireh, Bilal, Björnsson, Bergthor, Boggi, Ugo, Burdio, Fernando M., Butturini, Giovanni, Casadei, Riccardo, Coratti, Andrea, DHondt, Mathieu, Dokmak, Safi, Edwin, Bjorn, Esposito, Alessandro, Fabre, Jean M., Ferrari, Giovanni, Fteriche, Fadhel S., Fusai, Giuseppe K., Groot Koerkamp, Bas, Hackert, Thilo, Jah, Asif, Jang, Jin-Young, Kauffmann, Emanuele F., Keck, Tobias, Manzoni, Alberto, Marino, Marco V, Molenaar, Quintus, Pando, Elizabeth, Pessaux, Patrick, Pietrabissa, Andrea, Soonawalla, Zahir, Sutcliffe, Robert P., Timmermann, Lea, White, Steven, Yip, Vincent S., Zerbi, Alessandro, Abu Hilal, Mohammad, Besselink, Marc G., Chen, Jeffrey, van Ramshorst, Tess M. E., Lof, Sanne, Al-Sarireh, Bilal, Björnsson, Bergthor, Boggi, Ugo, Burdio, Fernando M., Butturini, Giovanni, Casadei, Riccardo, Coratti, Andrea, DHondt, Mathieu, Dokmak, Safi, Edwin, Bjorn, Esposito, Alessandro, Fabre, Jean M., Ferrari, Giovanni, Fteriche, Fadhel S., Fusai, Giuseppe K., Groot Koerkamp, Bas, Hackert, Thilo, Jah, Asif, Jang, Jin-Young, Kauffmann, Emanuele F., Keck, Tobias, Manzoni, Alberto, Marino, Marco V, Molenaar, Quintus, Pando, Elizabeth, Pessaux, Patrick, Pietrabissa, Andrea, Soonawalla, Zahir, Sutcliffe, Robert P., Timmermann, Lea, White, Steven, Yip, Vincent S., Zerbi, Alessandro, Abu Hilal, Mohammad, and Besselink, Marc G.

Abstract

BackgroundRobot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking.MethodsAn international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010-2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival.ResultsIn total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively.ConclusionsIn selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.

Published
2023
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6. Learning Curves of Minimally Invasive Distal Pancreatectomy in Experienced Pancreatic Centers

Author

Lof, Sanne, Claassen, Linda, Hannink, Gerjon, Al-Sarireh, Bilal, Björnsson, Bergthor, Boggi, Ugo, Burdio, Fernando, Butturini, Giovanni, Capretti, Giovanni, Casadei, Riccardo, Dokmak, Safi, Edwin, Bjorn, Esposito, Alessandro, Fabre, Jean M., Ferrari, Giovanni, Fretland, Asmund A., Fteriche, Fadhel S., Fusai, Giuseppe K., Giardino, Alessandro, Groot Koerkamp, Bas, DHondt, Mathieu, Jah, Asif, Kamarajah, Sivesh K., Kauffmann, Emanuele F., Keck, Tobias, van Laarhoven, Stijn, Manzoni, Alberto, Marino, Marco V., Marudanayagam, Ravi, Molenaar, Izaak Q., Pessaux, Patrick, Rosso, Edoardo, Salvia, Roberto, Soonawalla, Zahir, Souche, Regis, White, Steven, van Workum, Frans, Zerbi, Alessandro, Rosman, Camiel, Stommel, Martijn W. J., Abu Hilal, Mohammed, Besselink, Marc G., Lof, Sanne, Claassen, Linda, Hannink, Gerjon, Al-Sarireh, Bilal, Björnsson, Bergthor, Boggi, Ugo, Burdio, Fernando, Butturini, Giovanni, Capretti, Giovanni, Casadei, Riccardo, Dokmak, Safi, Edwin, Bjorn, Esposito, Alessandro, Fabre, Jean M., Ferrari, Giovanni, Fretland, Asmund A., Fteriche, Fadhel S., Fusai, Giuseppe K., Giardino, Alessandro, Groot Koerkamp, Bas, DHondt, Mathieu, Jah, Asif, Kamarajah, Sivesh K., Kauffmann, Emanuele F., Keck, Tobias, van Laarhoven, Stijn, Manzoni, Alberto, Marino, Marco V., Marudanayagam, Ravi, Molenaar, Izaak Q., Pessaux, Patrick, Rosso, Edoardo, Salvia, Roberto, Soonawalla, Zahir, Souche, Regis, White, Steven, van Workum, Frans, Zerbi, Alessandro, Rosman, Camiel, Stommel, Martijn W. J., Abu Hilal, Mohammed, and Besselink, Marc G.

Abstract

IMPORTANCE Understanding the learning curve of a new complex surgical technique helps to reduce potential patient harm. Current series on the learning curve of minimally invasive distal pancreatectomy (MIDP) are mostly small, single-center series, thus providing limited data. OBJECTIVE To evaluate the length of pooled learning curves of MIDP in experienced centers. DESIGN, SETTING, AND PARTICIPANTS This international, multicenter, retrospective cohort study included MIDP procedures performed from January 1, 2006, through June 30, 2019, in 26 European centers from 8 countries that each performed more than 15 distal pancreatectomies annually, with an overall experience exceeding 50 MIDP procedures. Consecutive patients who underwent elective laparoscopic or robotic distal pancreatectomy for all indications were included. Data were analyzed between September 1, 2021, and May 1, 2022. EXPOSURES The learning curve for MIDP was estimated by pooling data from all centers. MAIN OUTCOMES AND MEASURES The learning curvewas assessed for the primary textbook outcome (TBO), which is a composite measure that reflects optimal outcome, and for surgical mastery. Generalized additive models and a 2-piece linear model with a break point were used to estimate the learning curve length of MIDP. Case mix-expected probabilities were plotted and compared with observed outcomes to assess the association of changing case mix with outcomes. The learning curve also was assessed for the secondary outcomes of operation time, intraoperative blood loss, conversion to open rate, and postoperative pancreatic fistula grade B/C. RESULTS From a total of 2610 MIDP procedures, the learning curve analysis was conducted on 2041 procedures (mean [SD] patient age, 58 [15.3] years; among 2040 with reported sex, 1249 were female [61.2%] and 791 male [38.8%]). The 2-piece model showed an increase and eventually a break point for TBO at 85 procedures (95% CI, 13-157 procedures), with a plateau TBO rate at 70%. T

Published
2023
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7. Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer:An International, Retrospective, Cohort Study

Author

Chen, Jeffrey W, van Ramshorst, Tess M E, Lof, Sanne, Al-Sarireh, Bilal, Bjornsson, Bergthor, Boggi, Ugo, Burdio, Fernando, Butturini, Giovanni, Casadei, Riccardo, Coratti, Andrea, D'Hondt, Mathieu, Dokmak, Safi, Edwin, Bjørn, Esposito, Alessandro, Fabre, Jean M, Ferrari, Giovanni, Ftériche, Fadhel S, Fusai, Giuseppe K, Groot Koerkamp, Bas, Hackert, Thilo, Jah, Asif, Jang, Jin-Young, Kauffmann, Emanuele F, Keck, Tobias, Manzoni, Alberto, Marino, Marco V, Molenaar, Quintus, Pando, Elizabeth, Pessaux, Patrick, Pietrabissa, Andrea, Soonawalla, Zahir, Sutcliffe, Robert P, Timmermann, Lea, White, Steven, Yip, Vincent S, Zerbi, Alessandro, Abu Hilal, Mohammad, Besselink, Marc G, Chen, Jeffrey W, van Ramshorst, Tess M E, Lof, Sanne, Al-Sarireh, Bilal, Bjornsson, Bergthor, Boggi, Ugo, Burdio, Fernando, Butturini, Giovanni, Casadei, Riccardo, Coratti, Andrea, D'Hondt, Mathieu, Dokmak, Safi, Edwin, Bjørn, Esposito, Alessandro, Fabre, Jean M, Ferrari, Giovanni, Ftériche, Fadhel S, Fusai, Giuseppe K, Groot Koerkamp, Bas, Hackert, Thilo, Jah, Asif, Jang, Jin-Young, Kauffmann, Emanuele F, Keck, Tobias, Manzoni, Alberto, Marino, Marco V, Molenaar, Quintus, Pando, Elizabeth, Pessaux, Patrick, Pietrabissa, Andrea, Soonawalla, Zahir, Sutcliffe, Robert P, Timmermann, Lea, White, Steven, Yip, Vincent S, Zerbi, Alessandro, Abu Hilal, Mohammad, and Besselink, Marc G

Abstract

BACKGROUND: Robot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking.METHODS: An international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010-2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival.RESULTS: In total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively.CONCLUSIONS: In selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.

Published
2023

8. Learning Curves of Minimally Invasive Distal Pancreatectomy in Experienced Pancreatic Centers

Author

MS CGO, Cancer, Lof, Sanne, Claassen, Linda, Hannink, Gerjon, Al-Sarireh, Bilal, Björnsson, Bergthor, Boggi, Ugo, Burdio, Fernando, Butturini, Giovanni, Capretti, Giovanni, Casadei, Riccardo, Dokmak, Safi, Edwin, Bjørn, Esposito, Alessandro, Fabre, Jean M., Ferrari, Giovanni, Fretland, Asmund A., Ftériche, Fadhel S., Fusai, Giuseppe K., Giardino, Alessandro, Groot Koerkamp, Bas, D'Hondt, Mathieu, Jah, Asif, Kamarajah, Sivesh K., Kauffmann, Emanuele F., Keck, Tobias, Van Laarhoven, Stijn, Manzoni, Alberto, Marino, Marco V., Marudanayagam, Ravi, Molenaar, Izaak Q., Pessaux, Patrick, Rosso, Edoardo, Salvia, Roberto, Soonawalla, Zahir, Souche, Regis, White, Steven, Van Workum, Frans, Zerbi, Alessandro, Rosman, Camiel, Stommel, Martijn W.J., Abu Hilal, Mohammed, Besselink, Marc G., MS CGO, Cancer, Lof, Sanne, Claassen, Linda, Hannink, Gerjon, Al-Sarireh, Bilal, Björnsson, Bergthor, Boggi, Ugo, Burdio, Fernando, Butturini, Giovanni, Capretti, Giovanni, Casadei, Riccardo, Dokmak, Safi, Edwin, Bjørn, Esposito, Alessandro, Fabre, Jean M., Ferrari, Giovanni, Fretland, Asmund A., Ftériche, Fadhel S., Fusai, Giuseppe K., Giardino, Alessandro, Groot Koerkamp, Bas, D'Hondt, Mathieu, Jah, Asif, Kamarajah, Sivesh K., Kauffmann, Emanuele F., Keck, Tobias, Van Laarhoven, Stijn, Manzoni, Alberto, Marino, Marco V., Marudanayagam, Ravi, Molenaar, Izaak Q., Pessaux, Patrick, Rosso, Edoardo, Salvia, Roberto, Soonawalla, Zahir, Souche, Regis, White, Steven, Van Workum, Frans, Zerbi, Alessandro, Rosman, Camiel, Stommel, Martijn W.J., Abu Hilal, Mohammed, and Besselink, Marc G.

Published
2023

9. Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study

Author

Chen, Jeffrey W, Van Ramshorst, Tess ME, Lof, Sanne, Al-Sarireh, Bilal, Bjornsson, Bergthor, Boggi, Ugo, Burdio, Fernando, Butturini, Giovanni, Casadei, Riccardo, Coratti, Andrea, D'Hondt, Mathieu, Dokmak, Safi, Edwin, Bjørn, Esposito, Alessandro, Fabre, Jean M, Ferrari, Giovanni, Ftériche, Fadhel S, Fusai, Giuseppe K, Groot Koerkamp, Bas, Hackert, Thilo, Jah, Asif, Jang, Jin-Young, Kauffmann, Emanuele F, Keck, Tobias, Manzoni, Alberto, Marino, Marco V, Molenaar, Quintus, Pando, Elizabeth, Pessaux, Patrick, Pietrabissa, Andrea, Soonawalla, Zahir, Sutcliffe, Robert P, Timmermann, Lea, White, Steven, Yip, Vincent S, Zerbi, Alessandro, Abu Hilal, Mohammad, Besselink, Marc G, European Consortium On Minimally Invasive Pancreatic Surgery (E-MIPS), and Apollo - University of Cambridge Repository

Subjects
Cohort Studies, Pancreatic Neoplasms, Pancreatectomy, Treatment Outcome, Robotic Surgical Procedures, Operative Time, Humans, Laparoscopy, Robotics, Length of Stay, Retrospective Studies
Abstract

BACKGROUND: Robot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking. METHODS: An international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010-2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival. RESULTS: In total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively. CONCLUSIONS: In selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.

Published
2023

19. Learning Curves of Minimally Invasive Distal Pancreatectomy in Experienced Pancreatic Centers.

Author

Lof S, Claassen L, Hannink G, Al-Sarireh B, Björnsson B, Boggi U, Burdio F, Butturini G, Capretti G, Casadei R, Dokmak S, Edwin B, Esposito A, Fabre JM, Ferrari G, Fretland AA, Ftériche FS, Fusai GK, Giardino A, Groot Koerkamp B, D'Hondt M, Jah A, Kamarajah SK, Kauffmann EF, Keck T, van Laarhoven S, Manzoni A, Marino MV, Marudanayagam R, Molenaar IQ, Pessaux P, Rosso E, Salvia R, Soonawalla Z, Souche R, White S, van Workum F, Zerbi A, Rosman C, Stommel MWJ, Abu Hilal M, and Besselink MG

Subjects
Humans, Male, Female, Middle Aged, Pancreatectomy methods, Learning Curve, Pancreatic Fistula epidemiology, Pancreatic Fistula etiology, Retrospective Studies, Blood Loss, Surgical, Treatment Outcome, Postoperative Complications epidemiology, Postoperative Complications surgery, Pancreatic Neoplasms surgery, Laparoscopy methods, Surgeons
Abstract

Importance: Understanding the learning curve of a new complex surgical technique helps to reduce potential patient harm. Current series on the learning curve of minimally invasive distal pancreatectomy (MIDP) are mostly small, single-center series, thus providing limited data., Objective: To evaluate the length of pooled learning curves of MIDP in experienced centers., Design, Setting, and Participants: This international, multicenter, retrospective cohort study included MIDP procedures performed from January 1, 2006, through June 30, 2019, in 26 European centers from 8 countries that each performed more than 15 distal pancreatectomies annually, with an overall experience exceeding 50 MIDP procedures. Consecutive patients who underwent elective laparoscopic or robotic distal pancreatectomy for all indications were included. Data were analyzed between September 1, 2021, and May 1, 2022., Exposures: The learning curve for MIDP was estimated by pooling data from all centers., Main Outcomes and Measures: The learning curve was assessed for the primary textbook outcome (TBO), which is a composite measure that reflects optimal outcome, and for surgical mastery. Generalized additive models and a 2-piece linear model with a break point were used to estimate the learning curve length of MIDP. Case mix-expected probabilities were plotted and compared with observed outcomes to assess the association of changing case mix with outcomes. The learning curve also was assessed for the secondary outcomes of operation time, intraoperative blood loss, conversion to open rate, and postoperative pancreatic fistula grade B/C., Results: From a total of 2610 MIDP procedures, the learning curve analysis was conducted on 2041 procedures (mean [SD] patient age, 58 [15.3] years; among 2040 with reported sex, 1249 were female [61.2%] and 791 male [38.8%]). The 2-piece model showed an increase and eventually a break point for TBO at 85 procedures (95% CI, 13-157 procedures), with a plateau TBO rate at 70%. The learning-associated loss of TBO rate was estimated at 3.3%. For conversion, a break point was estimated at 40 procedures (95% CI, 11-68 procedures); for operation time, at 56 procedures (95% CI, 35-77 procedures); and for intraoperative blood loss, at 71 procedures (95% CI, 28-114 procedures). For postoperative pancreatic fistula, no break point could be estimated., Conclusion and Relevance: In experienced international centers, the learning curve length of MIDP for TBO was considerable with 85 procedures. These findings suggest that although learning curves for conversion, operation time, and intraoperative blood loss are completed earlier, extensive experience may be needed to master the learning curve of MIDP.

Published
2023
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