scholarly journals Comprehensive multi-component learning curve analysis of a single-surgeon series of laparoscopic distal pancreatectomy: Outcomes improve even with increasing complexity of cases

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e768
Author(s):  
A.P. Belgaumkar ◽  
J. Richardson ◽  
B. Jaber ◽  
M. Abu Hilal
Pancreatology ◽  
2013 ◽  
Vol 13 (4) ◽  
pp. S64
Author(s):  
Claudio Ricci ◽  
Riccardo Casadei ◽  
Salvatore Buscemi ◽  
Giovanni Taffurelli ◽  
Marielda D’ambra ◽  
...  

Author(s):  
Mushegh A. Sahakyan ◽  
Bård I. Røsok ◽  
Tore Tholfsen ◽  
Dyre Kleive ◽  
Anne Waage ◽  
...  

Abstract Background Distal pancreatectomy is the most common procedure in minimally-invasive pancreatic surgery. Data in the literature suggest that the learning curve flattens after performing up to 30 procedures. However, the exact number remains unclear. Methods The implementation and training with laparoscopic distal pancreatectomy (LDP) in a high-volume center were studied between 1997 and 2020. Perioperative outcomes and factors related to conversion were assessed. The individual experiences of four different surgeons (pioneer and adopters) performing LDP on a regular basis were examined. Results Six hundred forty LDPs were done accounting for 95% of all distal pancreatectomies performed throughout the study period. Conversion was needed in 14 (2.2%) patients due to intraoperative bleeding or tumor adherence to the major vasculature. Overall morbidity and mortality rates were 35 and 0.6%, respectively. Intra- and postoperative outcomes did not change for any of the surgeons within their first 40 cases. Operative time significantly decreased after the first 80 cases for the pioneer surgeon and did not change afterwards although the proportion of ductal adenocarcinoma increased. Tumor size increased after the first 80 cases for the first adopter without affecting the operative time. Conclusions In this nearly unselected cohort, no significant changes in surgical outcomes were observed throughout the first 40 LDPs for different surgeons. The exact number of procedures required to overcome the learning curve is difficult to determine as it seems to depend on patient selection policy and specifics of surgical training at the corresponding center.


2016 ◽  
Vol 26 (6) ◽  
pp. 470-474 ◽  
Author(s):  
Ido Nachmany ◽  
Niv Pencovich ◽  
Amir Ben-Yehuda ◽  
Guy Lahat ◽  
Richard Nakache ◽  
...  

Surgery Today ◽  
2014 ◽  
Vol 45 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Claudio Ricci ◽  
Riccardo Casadei ◽  
Salvatore Buscemi ◽  
Giovanni Taffurelli ◽  
Marielda D’Ambra ◽  
...  

2022 ◽  
Vol 2022 ◽  
pp. 1-8
Author(s):  
Peng Chen ◽  
Bin Zhou ◽  
Tao Wang ◽  
Xiao Hu ◽  
Yongqiang Ye ◽  
...  

Background. Laparoscopic distal pancreatectomy (LDP) has become a routine procedure in pancreatic surgery. Although robotic distal pancreatectomy (RDP) has not been popularized yet, it has shown new advantages in some aspects, and exploring its learning curve is of great significance for guiding clinical practice. Methods. 149 patients who received RDP and LDP in our surgical team were enrolled in this retrospective study. Patients were divided into two groups including LDP group and RDP group. The perioperative outcomes, histopathologic results, long-term postoperative complications, and economic cost were collected and compared between the two groups. The cumulative summation (CUSUM) analysis was used to explore the learning curve of RDP. Results. The hospital stay, postoperative first exhaust time, and first feeding time in the RDP group were better than those in the LDP group ( P < 0.05 ). The rate of spleen preservation in patients with benign and low-grade tumors in the RDP group was significantly higher than that of the LDP group ( P = 0.002 ), though the cost of operation and hospitalization was significantly higher ( P < 0.001 ). The learning curve of RDP in our center declined significantly with completing 32 cases. The average operation time, the hospital stay, and the time of gastrointestinal recovery were shorter after the learning curve node than before. Conclusion. RDP provides better postoperative recovery and is not difficult to replicate, but the high cost was still a major disadvantage of RDP.


2012 ◽  
Vol 64 (3) ◽  
pp. 179-183 ◽  
Author(s):  
Marco Braga ◽  
Cristina Ridolfi ◽  
Gianpaolo Balzano ◽  
Renato Castoldi ◽  
Nicolò Pecorelli ◽  
...  

Pancreatology ◽  
2013 ◽  
Vol 13 (3) ◽  
pp. S76
Author(s):  
Salvatore Buscemi ◽  
Claudio Ricci ◽  
Giovanni Taffurelli ◽  
Marielda D’Ambra ◽  
Nicola Antonacci ◽  
...  

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