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Technical Detail for Robot Assisted Pancreaticoduodenectomy
Published on: September 28, 2019
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Canadian practice patterns for pancreaticoduodenectomy
David P Cyr1, Jessica L Truong2, Jenny Lam-McCulloch1
1The Department of Surgery, University of Toronto and the Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|March 24, 2015
Summary
Canadian hepato-pancreatico-biliary surgeons show varied approaches to pancreaticoduodenectomy perioperative care, indicating evidence-practice gaps. Further research is needed to standardize techniques and improve patient outcomes.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Discordant practice patterns may stem from evidence-practice gaps or knowledge translation issues.
- Investigated perioperative management strategies for pancreaticoduodenectomy (PD) among Canadian hepato-pancreatico-biliary (HPB) surgeons.
Purpose of the Study:
- To examine current perioperative management strategies for pancreaticoduodenectomy (PD) in Canada.
- To identify evidence-practice gaps in the perioperative care of PD.
Main Methods:
- A web-based survey was developed focusing on perioperative measures for PD.
- The survey was distributed to all members of the Canadian Hepato-Pancreatico-Biliary Association.
Main Results:
- A 50% response rate was achieved from 74 surveyed HPB surgeons.
- Most surgeons (86.5%) use pancreaticojejunostomy for reconstruction, but techniques for drainage tubes, stents, octreotide, and intraoperative modalities vary.
- While 75.7% of surgeons frequently use preoperative biliary drainage, there's minimal agreement on criteria; postoperative care, including analgesia and nutrition timing, also shows variability.
Conclusions:
- Heterogeneity exists among Canadian HPB surgeons regarding PD perioperative care.
- Identified evidence-practice gaps in specific domains of pancreatic resections.
- Focused research can promote technical standardization and enhance patient outcomes post-PD.
