Introduction
Materials and methods
Study design
Terminology and definition
Statistical analysis
Results
Variable | N (%) or median (IQR) |
---|---|
Gender | |
Female | 59 (59.0) |
Male | 41 (41.0) |
Age (years) | 60 (53–73) |
Co-morbidity | |
None | 39 (39.0) |
One or more | 61 (61.0) |
ASA score | |
I | 5 (5.0) |
II | 48 (48.0) |
III | 47 (47.0) |
BMI (Kg/m2; median; range) | 25.2 (22.7–28.5) |
Previous abdominal surgery | |
No | 45 (45.0) |
Laparoscopic | 6 ( 6.0) |
Open | 49 (49.0) |
Tumor size (mm; median; range) | 25 (15–40) |
Tumor site | |
Neck | 19 (19.0) |
Body | 36 (36.0) |
Tai | 45 (45.0) |
Type of lesion | |
Solid neoplasm | 42 (42.0) |
Cystic neoplasm | 58 (58.0) |
Suspicion of malignancy | |
No | 41 (41.0) |
Yes | 59 (59.0) |
Completed learning curve (>17 procedures) | |
No | 43 (43.0) |
Yes | 57 (57.0) |
Cumulative procedures per surgeon (median; range) | 20 (7.5–32) |
Spleen resection | |
No | 21 (21.0) |
Yes | 79 (79.0) |
Type of pancreatic resection | |
Left pancreatectomy | 82 (82.0) |
Subtotal pancreatectomy | 18 (18.0) |
Parenchymal thickness at the resection line (mm; median; range) | 16.5 (12–22) |
Texture of the pancreatic parenchyma | |
Soft | 64 (64.0) |
Hard | 36 (36.0) |
Extended resection | |
No | 95 (95.0) |
Yes | 5 (5.0) |
Pathological diagnosis | |
PDAC | 14 (14.0) |
Non-PDAC | 86 (86.0) |
NET | 36 (36.0) |
IPMN | 17 (17.0) |
MCN | 14 (14.0) |
SCN | 7 (7.0) |
Others | 12 (12.0) |
Conversion rate | |
No | 81 (81.0) |
Yes | 19 (19.0) |
Postoperative course | N (%) |
---|---|
Mortality | 0 (100) |
Morbidity according to the C-D | |
No | 48 (48.0) |
1 | 13 (13.0) |
2 | 23 (23.0) |
3a | 5 (5.0) |
3b | 5 (5.0) |
4 | 1 (1.0) |
POPF according 2016 ISGPF definition | |
No | 71 (71.0) |
Grade B | 27 (27.0) |
Grade C | 2 (2.0) |
PPH according ISGPS | |
No | 91 (91.0) |
Grade A | 2 (2.0) |
Grade B | 5 (5.0) |
Grade C | 2 (2.0) |
Reoperation | |
No | 95 (95.0) |
Yes | 5 (5.0) |
LOS (days, median, range) | 9.5 (8–12 |
Variables | Univariate | Multivariate | ||||
---|---|---|---|---|---|---|
LDP | CLDP | P value | β ± SE | P value | Exclusion step | |
Gender | 0.047 | Last | ||||
Male (%) | 50 (84.7) | 9 (15.3) | 0.304 | Referent | ||
Female (%) | 31 (75.6) | 10 (24.4) | −1.8 ± 0.9 | |||
Age (years; median; range) | 60 (54–70) | 66 (51–75) | 0.473 | −0.1 ± 0.1 | 0.228 | 10th |
Co-morbidity | 0.035 | 0.606 | ||||
None (%) | 36 (92.3) | 3 (7.7) | Referent | 5th | ||
One or more (%) | 45 (73.7) | 16 (26.3) | 1.3 ± 2.5 | |||
ASA | ||||||
I (%) | 5 (100.0) | 0 (0.0) | 0.214 | −1.1 ± 1.7 | 0.502 | |
II (%) | 41 (85.4) | 7 (14.6) | * | * | 7th | |
III (%) | 35 (74.5) | 12 (25.5) | * | * | ||
BMI (Kg/m2; median; range) | 24.9 (22.8–27.9) | 27.6 (22.7–33.3) | 0.017 | 0.2 ± 0.1 | 0.011 | Last |
Previous abdominal surgery | ||||||
No (%) | 35 (77.8) | 10 (22.2) | Referent | 9th | ||
Laparoscopic (%) | 3 (50.0) | 3 (50.0) | 0.064 | 1.9 ± 2.2 | 0.388 | |
Open (%) | 43 (87.8) | 6 (12.2) | −0.2 ± 1.4 | 0.863 | ||
Size of lesions (mm; median; range) | 25 (16–40) | 10 (23–35) | 0.661 | 0.1 ± 0.1 | 0.649 | 6th |
Site of lesion | Last | |||||
Neck (%) | 13 (68.4) | 6 (31.6) | 0.055 | Referent | ||
Body (%) | 27 (75.0) | 9 (25.0) | −1.1 ± 0.9 | 0.258 | ||
Tail (%) | 41 (91.1) | 4 (8.9) | −2.1 ± 1.1 | 0.050 | ||
Type of lesion | 0.038 | 0.532 | 8th | |||
Solid neoplasm (%) | 30 (71.4) | 12 (28.6) | Referent | |||
Cystic neoplasm (%) | 51 (87.9) | 7 (12.1) | −0.7 ± 1.2 | |||
Suspicion of malignancy | 0.531 | 0.429 | 12th | |||
No (%) | 49 (83.1) | 10 (16.9) | Referent | |||
Yes (%) | 51 (87.9) | 7 (12.1) | 0.8 ± 1.1 | |||
PDAC | 0.086 | 0.232 | 11th | |||
No (%) | 72 (83.7) | 14 (16.3) | Referent | |||
Yes (%) | 9 (64.3) | 5 (36.7) | 2.5 ± 2.1 | |||
Learning curve | 0.547 | 0.882 | 2nd | |||
No (%) | 36 (83.7) | 7 (16.3) | Referent | |||
Yes (%) | 45 (78.9) | 12 (21.1) | 0.6 ± 3.9 | |||
Cumulative procedures per surgeon (median; range) | 19 (7–32) | 20 (11–33) | 0.849 | −0.1 ± 0.1 | 0.905 | 3rd |
Spleen resection | 0.213 | 1st | ||||
No (%) | 19 (90.5) | 2 (9.5) | Referent | 0.987 | ||
Yes (%) | 62 (78.5) | 17 (21.5) | −0.4 ± 3.1 | |||
Type of pancreatic resection | 0.002 | 0.006 | Last | |||
Left pancreatectomy (%) | 71 (86.6) | 11 (13.4) | Referent | |||
Subtotal pancreatectomy (%) | 10 (55.6) | 8 (44.4) | 2.4 ± 0.9 | |||
Parenchymal thickness at resection line (mm; median; range) | 16 (12–22) | 19 (12–22) | 0.833 | −0.1 ± 0.2 | 0.863 | 4th |
Texture of the pancreatic parenchyma | 0.328 | 0.148 | 13th | |||
Soft (%) | 50 (78.1) | 14 (21.9) | Referent | |||
Hard (%) | 31 (86.1) | 5 (13.9) | −1.5 ± 1.1 | |||
Extended resection | 0.219 | 0.205 | 14th | |||
No (%) | 78 (82.1) | 17 (17.9) | Referent | |||
Yes (%) | 3 (60.0) | 2 (40.0) | −2.5 ± 1.9 |
Score, points | Conversion probability in % (95% CI) | P value* |
---|---|---|
0 | Referent | Referent |
1 | 9.9 (0–28.7) | 0.296 |
2 | 10.7 (0–28.7) | 0.240 |
3 | 11.6 (0–28.6) | 0.181 |
4 | 12.5 (0–28.3) | 0.123 |
5 | 13.4 (0–27.8) | 0.069 |
6 | 14.4 (1.5–27.3) | 0.029 |
7 | 15.4 (4.2–26.7) | 0.007 |
8 | 16.5 (7.1–26.1) | 0.001 |
9 | 17.7 (9.4–25.9) | <0.001 |
10 | 18.9 (11.2–26.7) | <0.001 |
11 | 20.2 (11.6–28.8) | <0.001 |
12 | 21.6 (10.8–32.5) | <0.001 |
13 | 23.1 (9.1–37.1) | <0.001 |
14 | 24.5 (6.5–42.7) | 0.008 |
15 | 26.1 (3.5–48.7) | 0.024 |
16 | 27.8 (0.2–48.7) | 0.048 |
17 | 29.4 (0–62.2) | 0.079 |
18 | 31.2 (0–69.6) | 0.112 |