Laparoscopic surgery for pancreatic neoplasms: the European association for endoscopic surgery clinical consensus conference

B Edwin, MA Sahakyan, M Abu Hilal, MG Besselink, M Braga, JM Fabre, L Fernández-Cruz, B Gayet, SC Kim, IE Khatkov, EAES Consensus Conference Study Group

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Introduced more than 20 years ago, laparoscopic pancreatic surgery (LAPS) has not reached a uniform acceptance among HPB surgeons. As a result, there is no consensus regarding its use in patients with pancreatic neoplasms. This study, organized by the European Association for Endoscopic Surgery (EAES), aimed to develop consensus statements and clinical recommendations on the application of LAPS in these patients. Methods: An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open pancreatic surgery. Each panelist performed a critical appraisal of the literature and prepared evidence-based statements assessed by other panelists during Delphi process. The statements were further discussed during a one-day face-to-face meeting followed by the second round of Delphi. Modified statements were presented at the plenary session of the 24th International Congress of the EAES in Amsterdam and in a web-based survey. Results: LAPS included laparoscopic distal pancreatectomy (LDP), pancreatoduodenectomy (LPD), enucleation, central pancreatectomy, and ultrasound. In general, LAPS was found to be safe, especially in experienced hands, and also advantageous over an open approach in terms of intraoperative blood loss, postoperative recovery, and quality of life. Eighty-five percent or higher proportion of responders agreed with the majority (69.5%) of statements. However, the evidence is predominantly based on retrospective case–control studies and systematic reviews of these studies, clearly affected by selection bias. Furthermore, no randomized controlled trials (RCTs) have been published to date, although four RCTs are currently underway in Europe. Conclusions: LAPS is currently in its development and exploration stages, as defined by the international IDEAL framework for surgical innovation. LDP is feasible and safe, performed in many centers, while LPD is limited to few centers. RCTs and registry studies are essential to proceed with the assessment of LAPS. © 2017, European Association for Endoscopic Surgery (EAES).
Original languageEnglish
Pages (from-to)2023-2041
Number of pages19
JournalSurgical Endoscopy and Other Interventional Techniques
Volume31
Issue number5
DOIs
Publication statusPublished - 2017

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Pancreatic Neoplasms
Laparoscopy
Pancreatectomy
Pancreaticoduodenectomy
Randomized Controlled Trials
Postoperative Hemorrhage
Selection Bias
Registries
Retrospective Studies
Quality of Life

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Laparoscopic surgery for pancreatic neoplasms: the European association for endoscopic surgery clinical consensus conference. / Edwin, B; Sahakyan, MA; Abu Hilal, M; Besselink, MG; Braga, M; Fabre, JM; Fernández-Cruz, L; Gayet, B; Kim, SC; Khatkov, IE; Group, EAES Consensus Conference Study.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 31, No. 5, 2017, p. 2023-2041.

Research output: Contribution to journalArticle

Edwin, B, Sahakyan, MA, Abu Hilal, M, Besselink, MG, Braga, M, Fabre, JM, Fernández-Cruz, L, Gayet, B, Kim, SC, Khatkov, IE & Group, EAESCCS 2017, 'Laparoscopic surgery for pancreatic neoplasms: the European association for endoscopic surgery clinical consensus conference', Surgical Endoscopy and Other Interventional Techniques, vol. 31, no. 5, pp. 2023-2041. https://doi.org/10.1007/s00464-017-5414-3
Edwin, B ; Sahakyan, MA ; Abu Hilal, M ; Besselink, MG ; Braga, M ; Fabre, JM ; Fernández-Cruz, L ; Gayet, B ; Kim, SC ; Khatkov, IE ; Group, EAES Consensus Conference Study. / Laparoscopic surgery for pancreatic neoplasms: the European association for endoscopic surgery clinical consensus conference. In: Surgical Endoscopy and Other Interventional Techniques. 2017 ; Vol. 31, No. 5. pp. 2023-2041.
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abstract = "Background: Introduced more than 20 years ago, laparoscopic pancreatic surgery (LAPS) has not reached a uniform acceptance among HPB surgeons. As a result, there is no consensus regarding its use in patients with pancreatic neoplasms. This study, organized by the European Association for Endoscopic Surgery (EAES), aimed to develop consensus statements and clinical recommendations on the application of LAPS in these patients. Methods: An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open pancreatic surgery. Each panelist performed a critical appraisal of the literature and prepared evidence-based statements assessed by other panelists during Delphi process. The statements were further discussed during a one-day face-to-face meeting followed by the second round of Delphi. Modified statements were presented at the plenary session of the 24th International Congress of the EAES in Amsterdam and in a web-based survey. Results: LAPS included laparoscopic distal pancreatectomy (LDP), pancreatoduodenectomy (LPD), enucleation, central pancreatectomy, and ultrasound. In general, LAPS was found to be safe, especially in experienced hands, and also advantageous over an open approach in terms of intraoperative blood loss, postoperative recovery, and quality of life. Eighty-five percent or higher proportion of responders agreed with the majority (69.5{\%}) of statements. However, the evidence is predominantly based on retrospective case–control studies and systematic reviews of these studies, clearly affected by selection bias. Furthermore, no randomized controlled trials (RCTs) have been published to date, although four RCTs are currently underway in Europe. Conclusions: LAPS is currently in its development and exploration stages, as defined by the international IDEAL framework for surgical innovation. LDP is feasible and safe, performed in many centers, while LPD is limited to few centers. RCTs and registry studies are essential to proceed with the assessment of LAPS. {\circledC} 2017, European Association for Endoscopic Surgery (EAES).",
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T1 - Laparoscopic surgery for pancreatic neoplasms: the European association for endoscopic surgery clinical consensus conference

AU - Edwin, B

AU - Sahakyan, MA

AU - Abu Hilal, M

AU - Besselink, MG

AU - Braga, M

AU - Fabre, JM

AU - Fernández-Cruz, L

AU - Gayet, B

AU - Kim, SC

AU - Khatkov, IE

AU - Group, EAES Consensus Conference Study

PY - 2017

Y1 - 2017

N2 - Background: Introduced more than 20 years ago, laparoscopic pancreatic surgery (LAPS) has not reached a uniform acceptance among HPB surgeons. As a result, there is no consensus regarding its use in patients with pancreatic neoplasms. This study, organized by the European Association for Endoscopic Surgery (EAES), aimed to develop consensus statements and clinical recommendations on the application of LAPS in these patients. Methods: An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open pancreatic surgery. Each panelist performed a critical appraisal of the literature and prepared evidence-based statements assessed by other panelists during Delphi process. The statements were further discussed during a one-day face-to-face meeting followed by the second round of Delphi. Modified statements were presented at the plenary session of the 24th International Congress of the EAES in Amsterdam and in a web-based survey. Results: LAPS included laparoscopic distal pancreatectomy (LDP), pancreatoduodenectomy (LPD), enucleation, central pancreatectomy, and ultrasound. In general, LAPS was found to be safe, especially in experienced hands, and also advantageous over an open approach in terms of intraoperative blood loss, postoperative recovery, and quality of life. Eighty-five percent or higher proportion of responders agreed with the majority (69.5%) of statements. However, the evidence is predominantly based on retrospective case–control studies and systematic reviews of these studies, clearly affected by selection bias. Furthermore, no randomized controlled trials (RCTs) have been published to date, although four RCTs are currently underway in Europe. Conclusions: LAPS is currently in its development and exploration stages, as defined by the international IDEAL framework for surgical innovation. LDP is feasible and safe, performed in many centers, while LPD is limited to few centers. RCTs and registry studies are essential to proceed with the assessment of LAPS. © 2017, European Association for Endoscopic Surgery (EAES).

AB - Background: Introduced more than 20 years ago, laparoscopic pancreatic surgery (LAPS) has not reached a uniform acceptance among HPB surgeons. As a result, there is no consensus regarding its use in patients with pancreatic neoplasms. This study, organized by the European Association for Endoscopic Surgery (EAES), aimed to develop consensus statements and clinical recommendations on the application of LAPS in these patients. Methods: An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open pancreatic surgery. Each panelist performed a critical appraisal of the literature and prepared evidence-based statements assessed by other panelists during Delphi process. The statements were further discussed during a one-day face-to-face meeting followed by the second round of Delphi. Modified statements were presented at the plenary session of the 24th International Congress of the EAES in Amsterdam and in a web-based survey. Results: LAPS included laparoscopic distal pancreatectomy (LDP), pancreatoduodenectomy (LPD), enucleation, central pancreatectomy, and ultrasound. In general, LAPS was found to be safe, especially in experienced hands, and also advantageous over an open approach in terms of intraoperative blood loss, postoperative recovery, and quality of life. Eighty-five percent or higher proportion of responders agreed with the majority (69.5%) of statements. However, the evidence is predominantly based on retrospective case–control studies and systematic reviews of these studies, clearly affected by selection bias. Furthermore, no randomized controlled trials (RCTs) have been published to date, although four RCTs are currently underway in Europe. Conclusions: LAPS is currently in its development and exploration stages, as defined by the international IDEAL framework for surgical innovation. LDP is feasible and safe, performed in many centers, while LPD is limited to few centers. RCTs and registry studies are essential to proceed with the assessment of LAPS. © 2017, European Association for Endoscopic Surgery (EAES).

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DO - 10.1007/s00464-017-5414-3

M3 - Article

VL - 31

SP - 2023

EP - 2041

JO - Surgical Endoscopy

JF - Surgical Endoscopy

SN - 0930-2794

IS - 5

ER -