TY - JOUR
T1 - International expert consensus on laparoscopic pancreaticoduodenectomy
AU - Qin, Renyi
AU - Kendrick, Michael L.
AU - Wolfgang, Christopher L.
AU - Edil, Barish H.
AU - Palanivelu, Chinnusamy
AU - Parks, Rowan W.
AU - Yang, Yinmo
AU - He, Jin
AU - Zhang, Taiping
AU - Mou, Yiping
AU - Yu, Xianjun
AU - Peng, Bing
AU - Senthilnathan, Palanisamy
AU - Han, Ho-Seong
AU - Lee, Jae Hoon
AU - Unno, Michiaki
AU - Damink, Steven W. M. Olde
AU - Bansal, Virinder Kumar
AU - Chow, Pierce
AU - Cheung, Tan To
AU - Choi, Nim
AU - Tien, Yu-Wen
AU - Wang, Chengfeng
AU - Fok, Manson
AU - Cai, Xiujun
AU - Zou, Shengquan
AU - Peng, Shuyou
AU - Zhao, Yupei
PY - 2020/8
Y1 - 2020/8
N2 - Importance: While laparoscopic pancreaticoduodenectomy (LPD) is being adopted with increasing enthusiasm worldwide, it is still challenging for both technical and anatomical reasons. Currently, there is no consensus on the technical standards for LPD.Objective: The aim of this consensus statement is to guide the continued safe progression and adoption of LPD.Evidence Review: An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open pancreaticoduodenectomy. Statements were produced upon reviewing the literature and assessed by the members of the expert panel. The literature search and its critical appraisal were limited to articles published in English during the period from 1994 to 2019. The Web of Science, Medline, and Cochrane Library and Clinical Trials databases were searched, The search strategy included, but was not limited to, the terms 'laparoscopic', 'pancreaticoduodenectomy, 'pancreatoduodenectomy', 'Whipple's operation', and 'minimally invasive surgery'. Reference lists from the included articles were manually checked for any additional studies, which were included when appropriate. Delphi method was used to establish expert consensus and the AGREE II-GRS Instrument was applied to assess the methodological quality and externally validate the final statements. The statements were further discussed during a one-day face-to-face meeting at the 1st Summit on Minimally Invasive Pancreatico-Biliary Surgery in Wuhan, China.Findings: Twenty-eight international experts from 8 countries constructed the expert panel. Sixteen statements were produced by the members of the expert panel. At least 80% of responders agreed with the majority (80%) of statements. Other than three randomized controlled trials published to date, most evidences were based on level 3 or 4 studies according to the AGREE II-GRS Instrument.Conclusions and Relevance: The Wuhan international expert consensus meeting on LPD has produced a set of clinical practice statements for the safe development and progression of LPD. LPD is currently in its development and exploration stages, as defined by the international IDEAL framework for surgical innovation. More robust randomized controlled trial and registry study are essential to proceed with the assessment of LPD.
AB - Importance: While laparoscopic pancreaticoduodenectomy (LPD) is being adopted with increasing enthusiasm worldwide, it is still challenging for both technical and anatomical reasons. Currently, there is no consensus on the technical standards for LPD.Objective: The aim of this consensus statement is to guide the continued safe progression and adoption of LPD.Evidence Review: An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open pancreaticoduodenectomy. Statements were produced upon reviewing the literature and assessed by the members of the expert panel. The literature search and its critical appraisal were limited to articles published in English during the period from 1994 to 2019. The Web of Science, Medline, and Cochrane Library and Clinical Trials databases were searched, The search strategy included, but was not limited to, the terms 'laparoscopic', 'pancreaticoduodenectomy, 'pancreatoduodenectomy', 'Whipple's operation', and 'minimally invasive surgery'. Reference lists from the included articles were manually checked for any additional studies, which were included when appropriate. Delphi method was used to establish expert consensus and the AGREE II-GRS Instrument was applied to assess the methodological quality and externally validate the final statements. The statements were further discussed during a one-day face-to-face meeting at the 1st Summit on Minimally Invasive Pancreatico-Biliary Surgery in Wuhan, China.Findings: Twenty-eight international experts from 8 countries constructed the expert panel. Sixteen statements were produced by the members of the expert panel. At least 80% of responders agreed with the majority (80%) of statements. Other than three randomized controlled trials published to date, most evidences were based on level 3 or 4 studies according to the AGREE II-GRS Instrument.Conclusions and Relevance: The Wuhan international expert consensus meeting on LPD has produced a set of clinical practice statements for the safe development and progression of LPD. LPD is currently in its development and exploration stages, as defined by the international IDEAL framework for surgical innovation. More robust randomized controlled trial and registry study are essential to proceed with the assessment of LPD.
KW - Consensus
KW - pancreaticoduodenectomy
KW - laparoscopy
KW - Delphi technique
KW - PYLORUS-PRESERVING PANCREATICODUODENECTOMY
KW - MINIMALLY INVASIVE PANCREATICODUODENECTOMY
KW - MAJOR VENOUS RESECTION
KW - MATCHED-PAIR ANALYSIS
KW - QUALITY-OF-LIFE
KW - LONG-TERM
KW - LEARNING-CURVE
KW - DUCTAL ADENOCARCINOMA
KW - DISTAL PANCREATECTOMY
KW - ONCOLOGICAL OUTCOMES
U2 - 10.21037/hbsn-20-446
DO - 10.21037/hbsn-20-446
M3 - (Systematic) Review article
C2 - 32832497
SN - 2304-3881
VL - 9
SP - 464
EP - 483
JO - Hepatobiliary Surgery and Nutrition
JF - Hepatobiliary Surgery and Nutrition
IS - 4
ER -