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Review
. 2020 Jan;271(1):1-14.
doi: 10.1097/SLA.0000000000003590.

The Miami International Evidence-based Guidelines on Minimally Invasive Pancreas Resection

Horacio J Asbun  1 , Alma L Moekotte  2   3 , Frederique L Vissers  3 , Filipe Kunzler  1 , Federica Cipriani  4 , Adnan Alseidi  5 , Michael I D'Angelica  6 , Alberto Balduzzi  7 , Claudio Bassi  7 , Bergthor Björnsson  8 , Ugo Boggi  9 , Mark P Callery  10 , Marco Del Chiaro  11 , Felipe J Coimbra  12 , Claudius Conrad  13 , Andrew Cook  14 , Alessandro Coppola  15 , Christos Dervenis  16 , Safi Dokmak  17 , Barish H Edil  18 , Bjørn Edwin  19 , Pier C Giulianotti  20 , Ho-Seong Han  21 , Paul D Hansen  22 , Nicky van der Heijde  2   3 , Jony van Hilst  3 , Caitlin A Hester  23 , Melissa E Hogg  24 , Nicolas Jarufe  25 , D Rohan Jeyarajah  26 , Tobias Keck  27 , Song Cheol Kim  28 , Igor E Khatkov  29 , Norihiro Kokudo  30 , David A Kooby  31 , Maarten Korrel  3 , Francisco J de Leon  32 , Nuria Lluis  33 , Sanne Lof  2   3 , Marcel A Machado  34 , Nicolas Demartines  35 , John B Martinie  36 , Nipun B Merchant  37 , I Quintus Molenaar  38 , Cassadie Moravek  39 , Yi-Ping Mou  40 , Masafumi Nakamura  41 , William H Nealon  42 , Chinnusamy Palanivelu  43 , Patrick Pessaux  44 , Henry A Pitt  45 , Patricio M Polanco  23 , John N Primrose  2 , Arab Rawashdeh  2 , Dominic E Sanford  46 , Palanisamy Senthilnathan  43 , Shailesh V Shrikhande  47 , John A Stauffer  48 , Kyoichi Takaori  49 , Mark S Talamonti  24 , Chung N Tang  50 , Charles M Vollmer  51 , Go Wakabayashi  52 , R Matthew Walsh  53 , Shin-E Wang  54 , Michael J Zinner  1 , Christopher L Wolfgang  55 , Amer H Zureikat  56 , Maurice J Zwart  3 , Kevin C Conlon  57 , Michael L Kendrick  58 , Herbert J Zeh  56 , Mohammad Abu Hilal  2   59 , Marc G Besselink  3 ; International Study Group on Minimally Invasive Pancreas Surgery (I-MIPS)
Affiliations
Review

The Miami International Evidence-based Guidelines on Minimally Invasive Pancreas Resection

Horacio J Asbun et al. Ann Surg. 2020 Jan.

Abstract

Objective: The aim of this study was to develop and externally validate the first evidence-based guidelines on minimally invasive pancreas resection (MIPR) before and during the International Evidence-based Guidelines on Minimally Invasive Pancreas Resection (IG-MIPR) meeting in Miami (March 2019).

Summary background data: MIPR has seen rapid development in the past decade. Promising outcomes have been reported by early adopters from high-volume centers. Subsequently, multicenter series as well as randomized controlled trials were reported; however, guidelines for clinical practice were lacking.

Methods: The Scottisch Intercollegiate Guidelines Network (SIGN) methodology was used, incorporating these 4 items: systematic reviews using PubMed, Embase, and Cochrane databases to answer clinical questions, whenever possible in PICO style, the GRADE approach for assessment of the quality of evidence, the Delphi method for establishing consensus on the developed recommendations, and the AGREE-II instrument for the assessment of guideline quality and external validation. The current guidelines are cosponsored by the International Hepato-Pancreato-Biliary Association, the Americas Hepato-Pancreato-Biliary Association, the Asian-Pacific Hepato-Pancreato-Biliary Association, the European-African Hepato-Pancreato-Biliary Association, the European Association for Endoscopic Surgery, Pancreas Club, the Society of American Gastrointestinal and Endoscopic Surgery, the Society for Surgery of the Alimentary Tract, and the Society of Surgical Oncology.

Results: After screening 16,069 titles, 694 studies were reviewed, and 291 were included. The final 28 recommendations covered 6 topics; laparoscopic and robotic distal pancreatectomy, central pancreatectomy, pancreatoduodenectomy, as well as patient selection, training, learning curve, and minimal annual center volume required to obtain optimal outcomes and patient safety.

Conclusion: The IG-MIPR using SIGN methodology give guidance to surgeons, hospital administrators, patients, and medical societies on the use and outcome of MIPR as well as the approach to be taken regarding this challenging type of surgery.

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References

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