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关于微创胰腺切除术的意见及应用的全球调查

Worldwide survey on opinions and use of minimally invasive pancreatic resection.

作者信息

van Hilst Jony, de Rooij Thijs, Abu Hilal Mohammed, Asbun Horacio J, Barkun Jeffrey, Boggi Uggo, Busch Olivier R, Conlon Kevin C P, Dijkgraaf Marcel G, Han Ho-Seong, Hansen Paul D, Kendrick Michael L, Montagnini Andre L, Palanivelu Chinnusamy, Røsok Bård I, Shrikhande Shailesh V, Wakabayashi Go, Zeh Herbert J, Vollmer Charles M, Kooby David A, Besselink Marc G H

机构信息

Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.

Department of Surgery, Southampton University Hospital, Southampton, UK.

出版信息

HPB (Oxford). 2017 Mar;19(3):190-204. doi: 10.1016/j.hpb.2017.01.011. Epub 2017 Feb 17.

Abstract

BACKGROUND

The introduction of minimally invasive pancreatic resection (MIPR) into surgical practice has been slow. The worldwide utilization of MIPR and attitude towards future perspectives of MIPR remains unknown.

METHODS

An anonymous survey on MIPR was sent to the members of six international associations of Hepato-Pancreato-Biliary (HPB) surgery.

RESULTS

The survey was completed by 435 surgeons from 50 countries, with each surgeon performing a median of 22 (IQR 12-40) pancreatic resections annually. Minimally invasive distal pancreatectomy (MIDP) was performed by 345 (79%) surgeons and minimally invasive pancreatoduodenectomy (MIPD) by 124 (29%). The median total personal experience was 20 (IQR 10-50) MIDPs and 12 (IQR 4-40) MIPDs. Current superiority for MIDP was claimed by 304 (70%) and for MIPD by 44 (10%) surgeons. The most frequently mentioned reason for not performing MIDP (54/90 (60%)) and MIPD (193/311 (62%)) was lack of specific training. Most surgeons (394/435 (90%)) would consider participating in an international registry on MIPR.

DISCUSSION

This worldwide survey showed that most participating HPB surgeons value MIPR as a useful development, especially for MIDP, but the role and implementation of MIPD requires further assessment. Most HPB surgeons would welcome specific training in MIPR and the establishment of an international registry.

摘要

背景

微创胰腺切除术(MIPR)引入外科实践的进程缓慢。MIPR在全球的应用情况以及对其未来前景的态度尚不清楚。

方法

向六个国际肝胆胰外科(HPB)协会的成员发送了一份关于MIPR的匿名调查问卷。

结果

来自50个国家的435名外科医生完成了调查,每位外科医生每年平均进行22例(四分位间距12 - 40)胰腺切除术。345名(79%)外科医生进行了微创远端胰腺切除术(MIDP),124名(29%)进行了微创胰十二指肠切除术(MIPD)。个人MIDP的总经验中位数为20例(四分位间距10 - 50),MIPD为12例(四分位间距4 - 40)。304名(70%)外科医生认为目前MIDP更具优势,44名(10%)认为MIPD更具优势。未进行MIDP(54/90(60%))和MIPD(193/311(62%))最常被提及的原因是缺乏专项培训。大多数外科医生(394/435(90%))会考虑参与MIPR的国际登记。

讨论

这项全球调查显示,大多数参与调查的HPB外科医生认为MIPR是一项有益的进展,尤其是对于MIDP,但MIPD的作用和实施需要进一步评估。大多数HPB外科医生欢迎MIPR的专项培训以及建立国际登记。

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