Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Ann Surg. 2024 Jan 1;279(1):45-57. doi: 10.1097/SLA.0000000000006006. Epub 2023 Jul 14.
To develop and update evidence-based and consensus-based guidelines on laparoscopic and robotic pancreatic surgery.
Minimally invasive pancreatic surgery (MIPS), including laparoscopic and robotic surgery, is complex and technically demanding. Minimizing the risk for patients requires stringent, evidence-based guidelines. Since the International Miami Guidelines on MIPS in 2019, new developments and key publications have been reported, necessitating an update.
Evidence-based guidelines on 22 topics in 8 domains were proposed: terminology, indications, patients, procedures, surgical techniques and instrumentation, assessment tools, implementation and training, and artificial intelligence. The Brescia Internationally Validated European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS, September 2022) used the Scottish Intercollegiate Guidelines Network (SIGN) methodology to assess the evidence and develop guideline recommendations, the Delphi method to establish consensus on the recommendations among the Expert Committee, and the AGREE II-GRS tool for guideline quality assessment and external validation by a Validation Committee.
Overall, 27 European experts, 6 international experts, 22 international Validation Committee members, 11 Jury Committee members, 18 Research Committee members, and 121 registered attendees of the 2-day meeting were involved in the development and validation of the guidelines. In total, 98 recommendations were developed, including 33 on laparoscopic, 34 on robotic, and 31 on general MIPS, covering 22 topics in 8 domains. Out of 98 recommendations, 97 reached at least 80% consensus among the experts and congress attendees, and all recommendations were externally validated by the Validation Committee.
The EGUMIPS evidence-based guidelines on laparoscopic and robotic MIPS can be applied in current clinical practice to provide guidance to patients, surgeons, policy-makers, and medical societies.
制定和更新腹腔镜和机器人胰腺手术的循证和共识指南。
微创胰腺手术（MIPS），包括腹腔镜和机器人手术，具有复杂性和技术要求高的特点。为了降低患者的风险，需要严格的循证指南。自 2019 年国际迈阿密 MIPS 指南以来，已经报告了新的发展和关键出版物，因此需要进行更新。
针对 8 个领域的 22 个主题提出了循证指南：术语、适应证、患者、手术、手术技术和仪器、评估工具、实施和培训、人工智能。2022 年 9 月，意大利布雷西亚国际验证的微创胰腺手术欧洲指南（EGUMIPS）采用苏格兰校际指南网络（SIGN）方法评估证据并制定指南建议，采用德尔菲法在专家委员会中就建议达成共识，并采用 AGREE II-GRS 工具由验证委员会对指南质量进行评估和外部验证。
共有 27 名欧洲专家、6 名国际专家、22 名国际验证委员会成员、11 名评审委员会成员、18 名研究委员会成员和 121 名为期两天的会议注册参加者参与了指南的制定和验证。总共制定了 98 条建议，其中 33 条涉及腹腔镜手术，34 条涉及机器人手术，31 条涉及一般 MIPS，涵盖 8 个领域的 22 个主题。在 98 条建议中，有 97 条建议在专家和与会代表中至少达到了 80%的共识，所有建议均由验证委员会进行了外部验证。
EGUMIPS 关于腹腔镜和机器人 MIPS 的循证指南可应用于当前的临床实践，为患者、外科医生、决策者和医学协会提供指导。
