28 | wetenschapsdag 2023 Sessie 1a: Viatris: Pantastische Pancreas-Perikelen x5 Auteurs M. Zwart, B. den Broek, D. Paijens, T. Geraedts, R. Schipper, S. Zwetsloot, A. Comandatore, O. Busch, K. Tran, M. Luyer, J. Schreinemakers, J. Wijsman, G. van der Schelling, I. de Hingh, S. Mieog, B. Bonsing, K. Takagi, R. de Wilde, L. Morelli, H. Zeh, A. Zureikat, M. Hogg, B. Groot Koerkamp, M. Besselink, for the Dutch Pancreatic Cancer Group Abstract titel Video analysis of gastro-jejunostomy to predict delayed gastric emptying after robotic pancreatoduodenectomy Background Robotic pancreatoduodenectomy (RPD) has proven to be as safe as open pancreatoduodenectomy (OPD), sometimes even more favorable in terms of overall length of hospital stay and complication rates. However, postoperative incidence of morbidity is still substantial, such as delayed gastric emptying. To this day, improved surgical performance has not yet been linked to a decrease in delayed gastric emptying in RPD. The aim of this study is to identify learning curves for robotic gastric anastomosis during RPD and the predictive value of the objective structured assessment of technical skills (OSATS) score for delayed gastric emptying according to the Birkmeyer and UPMC method. Methods Videos of gastric anastomosis during RPD were analyzed in a retrospective multicenter (LAELAPS 3) cohort by two blinded graders. Surgical performance was scored with OSATS. The main outcome measures are the combined OSATS scores of two blinded graders over time (learning curve). Secondary outcome is the correlation between OSATS scores and delayed gastric emptying (DGE, grade B/C). Results Videos from 192 gastric anastomosis were included. DGE occurred in 42/192 (21.9%) of patients. Mean OSATS score was 22.5 (SD±5.0) and was significantly predictive for DGE (AUC 0.668, P<0.001). The significant predictive OSATS elements were: Gentleness (AUC 0.719, P<0.001), instrument handling (AUC 0.595 P=0.043), tissue exposure (AUC 0.625, P=0.009), summary score (AUC 0.665, P25 points remained a consistent predictor (OR 0.344, P=0.028).
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