Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy; Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam, the Netherlands.
Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam, the Netherlands; Department of Surgery, OLVG, Amsterdam, the Netherlands.
HPB (Oxford). 2024 Jan;26(1):63-72. doi: 10.1016/j.hpb.2023.09.004. Epub 2023 Sep 6.
Evidence on the value of minimally invasive pancreatic surgery (MIPS) has been increasing but it is unclear how this has influenced the view of pancreatic surgeons on MIPS.
An anonymous survey was sent to members of eight international Hepato-Pancreato-Biliary Associations. Outcomes were compared with the 2016 international survey.
Overall, 315 surgeons from 47 countries participated. The median volume of pancreatic resections per center was 70 (IQR 40-120). Most surgeons considered minimally invasive distal pancreatectomy (MIDP) superior to open (ODP) (94.6%) and open pancreatoduodenectomy (OPD) superior to minimally invasive (MIPD) (67.9%). Since 2016, there has been an increase in the number of surgeons performing both MIDP (79%-85.7%, p = 0.024) and MIPD (29%-45.7%, p < 0.001), and an increase in the use of the robot-assisted approach for both MIDP (16%-45.6%, p < 0.001) and MIPD (23%-47.9%, p < 0.001). The use of laparoscopy remained stable for MIDP (91% vs. 88.1%, p = 0.245) and decreased for MIPD (51%-36.8%, p = 0.024).
This survey showed considerable changes of MIPS since 2016 with most surgeons considering MIDP superior to ODP and an increased use of robot-assisted MIPS. Surgeons prefer OPD and therefore the value of MIPD remains to be determined in randomized trials.
微创胰腺手术（MIPS）的价值证据不断增加，但尚不清楚这对胰腺外科医生对 MIPS 的看法有何影响。
向八个国际肝胆胰协会的成员发送了匿名调查。将结果与 2016 年的国际调查进行了比较。
共有来自 47 个国家的 315 名外科医生参加了此次调查。中心胰腺切除术的中位数为 70（IQR 40-120）。大多数外科医生认为微创胰体尾切除术（MIDP）优于开放胰体尾切除术（ODP）（94.6%），开放胰十二指肠切除术（OPD）优于微创胰十二指肠切除术（MIPD）（67.9%）。自 2016 年以来，同时进行 MIDP（79%-85.7%，p=0.024）和 MIPD（29%-45.7%，p<0.001）的外科医生数量有所增加，同时使用机器人辅助方法进行 MIDP（16%-45.6%，p<0.001）和 MIPD（23%-47.9%，p<0.001）的外科医生数量也有所增加。MIDP 中腹腔镜的使用保持稳定（91%对 88.1%，p=0.245），而 MIPD 中的腹腔镜使用则减少（51%-36.8%，p=0.024）。
本调查显示，自 2016 年以来，MIPS 发生了相当大的变化，大多数外科医生认为 MIDP 优于 ODP，并且机器人辅助 MIPS 的使用有所增加。外科医生更喜欢 OPD，因此 MIPD 的价值仍需在随机试验中确定。
