The Brescia Internationally Validated European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS)

Area of Science:

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

Background:

• Minimally invasive pancreatic surgery (MIPS), encompassing laparoscopic and robotic approaches, presents significant technical challenges.
• Existing guidelines require updating due to advancements and new publications since the 2019 International Miami Guidelines.
• Establishing stringent, evidence-based guidelines is crucial for minimizing patient risks in complex pancreatic procedures.

Purpose of the Study:

• To develop and update evidence-based and consensus-based guidelines for laparoscopic and robotic pancreatic surgery.
• To address 22 key topics across 8 domains relevant to MIPS, including AI and training.

Main Methods:

• Utilized the Scottish Intercollegiate Guidelines Network (SIGN) methodology for evidence assessment and recommendation development.
• Employed the Delphi method for expert consensus building and the AGREE II-GRS tool for guideline quality assessment.
• Involved a multidisciplinary expert committee, validation committee, and international experts in guideline development and validation.

Main Results:

• Developed 98 recommendations covering general, laparoscopic, and robotic MIPS across 22 topics.
• Achieved over 80% consensus on 97 out of 98 recommendations from experts and attendees.
• All recommendations underwent external validation by a dedicated Validation Committee.

Conclusions:

• The Brescia Internationally Validated European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS) provide current, evidence-based guidance.
• These guidelines are applicable in clinical practice to inform patients, surgeons, policymakers, and medical societies.
• EGUMIPS promotes standardized, safe, and effective minimally invasive pancreatic surgery.