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The Miami International Evidence-based Guidelines on Minimally Invasive Pancreas Resection.

Horacio J Asbun1, Alma L Moekotte2,3, Frederique L Vissers3

  • 1Division of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, FL.

Annals of Surgery
|October 1, 2019
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Summary
This summary is machine-generated.

This study developed evidence-based guidelines for minimally invasive pancreas resection (MIPR). These guidelines provide crucial direction for surgeons and institutions on optimizing outcomes and patient safety in MIPR procedures.

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Evidence-Based Medicine

Background:

  • Minimally invasive pancreas resection (MIPR) has advanced rapidly, with promising results from early adopters.
  • Despite reported outcomes, a lack of clinical practice guidelines hindered widespread adoption and standardization.
  • The need for evidence-based recommendations became apparent due to the increasing complexity and adoption of MIPR techniques.

Purpose of the Study:

  • To develop and externally validate the first evidence-based guidelines for minimally invasive pancreas resection (MIPR).
  • To provide comprehensive guidance on MIPR procedures, patient selection, and training.
  • To establish standards for optimal outcomes and patient safety in MIPR.

Main Methods:

  • Utilized the Scottish Intercollegiate Guidelines Network (SIGN) methodology.
  • Conducted systematic reviews of PubMed, Embase, and Cochrane databases.
  • Employed the GRADE approach for evidence quality assessment and the Delphi method for consensus on recommendations.

Main Results:

  • Screened 16,069 titles, reviewed 694 studies, and included 291.
  • Developed 28 recommendations covering 6 key topics in MIPR.
  • Recommendations address laparoscopic/robotic distal pancreatectomy, central pancreatectomy, pancreatoduodenectomy, patient selection, training, learning curves, and minimum annual center volume.

Conclusions:

  • The International Evidence-based Guidelines on Minimally Invasive Pancreas Resection (IG-MIPR) provide essential guidance for surgeons and administrators.
  • These guidelines address the use, outcomes, and approach for minimally invasive pancreas resection.
  • The IG-MIPR guidelines aim to enhance patient safety and optimize outcomes in this complex surgical field.