wetenschapsdag 2023 | 23 Sessie 1a: Viatris: Pantastische Pancreas-Perikelen x2 Auteurs A.M.L.H. Emmen, N. de Graaf, I.E. Khatkov, O.R. Busch, S. Dokmak, U. Boggi, B. Groot Koerkamp, G. Ferrari, I.Q. Molenaar, O. Saint-Marc, M. Ramera, D.J. Lips, J.S.D. Mieog, M.D.P. Luyer, T. Keck, M. D’Hondt, F.R. Souche, B. Edwin, T. Hackert, M.S.L. Liem, A. Iben-Khayat, H.C. Van Santvoort, M. Mazzola, R.F. De Wilde, E.F. Kauffmann, B. Aussilhou, S. Festen, R. Izrailov, P. Tyutyunnik, M.G. Besselink*, M. Abu Hilal*, for the European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) Abstract titel Implementation and outcome of minimally invasive pancreatoduodenectomy in Europe: A critical appraisal of the first 3 years of the E-MIPS registry Background International multicenter audit-based studies focusing on outcomes of minimally invasive pancreatoduodenectomy (MIPD) are lacking. The European registry for Minimally Invasive Pancreatic Surgery (E-MIPS) is an E-AHPBA endorsed registry which aims to monitor and safeguard the introduction of MIPD in Europe. Methods A planned analysis of outcomes among consecutive patients after MIPD from 45 centres in 14 European countries in the E-MIPS registry (2019-2021). Main outcomes of interest were major morbidity (Clavien-Dindo grade ≥3) and 30-day/in-hospital mortality. Results Overall, 1,336 patients after MIPD were included (835 robotassisted (R-MIPD) and 501 laparoscopic MIPD (L-MIPD)). Overall, 20 centres performed R-MIPD, 15 centres L-MIPD, and 10 centres both. Between 2019 and 2021, the rate of centres performing L-MIPD decreased from 46.9% to 25%, whereas for R-MIPD this increased from 46.9% to 65.6%. Overall, the rate of major morbidity was 41.2%, 30-day/in-hospital mortality 4.5%, conversion rate 9.7%, postoperative pancreatic fistula grade B/C 22.7%, and postpancreatectomy haemorrhage grade B/C 10.8%. Median length of hospital stay was 12 days [IQR 8-21]. The number of centres meeting the Miami Guidelines cut-off of ≥20 MIPDs annually increased from 9 (28.1%) in 2019 to 12 (37.5%) in 2021 (P=0.424). Rates of conversion (7.4% vs 14.8% P<0.001) and reoperation (8.9% vs 15.1%) P<0.001) were lower in centres that met the Miami cut-off. Conclusion During the first 3 years of the pan-European MIPS registry, morbidity and mortality rates after MIPD were acceptable. A shift is ongoing from L-MIPD to R-MIPD. Variations in outcomes should be further evaluated over a longer time period.
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