• Tess M E van Ramshorst, Alessandro Giani, Michele Mazzola, Safi Dokmak, Fadhel Samir Ftériche, Alessandro Esposito, Matteo de Pastena, Sanne Lof, Bjørn Edwin, Mushegh Sahakyan, Ugo Boggi, Emanuele Federico Kauffman, Jean Michel Fabre, Regis Francois Souche, Alessandro Zerbi, Giovanni Butturini, Quintus Molenaar, Bilal Al-Sarireh, Marco V Marino, Tobias Keck, Steven A White, Riccardo Casadei, Fernando Burdio, Bergthor Björnsson, Zahir Soonawalla, KoerkampBas GrootBG0000-0003-1917-6973Department of Surgery, Erasmus Medical Centre, Rotterdam, theNetherlands., Giuseppe Kito Fusai, Patrick Pessaux, Asif Jah, Andrea Pietrabissa, Thilo Hackert, Mathieu D'Hondt, Elizabeth Pando, Marc G Besselink, Giovanni Ferrari, HilalMohammad AbuMADepartment of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK., and European Consortium on Minimally Invasive Pancreatic Surgery.
• Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
• Br J Surg. 2022 Dec 13; 110 (1): 768376-83.

BackgroundBenchmarking is an important tool for quality comparison and improvement. However, no benchmark values are available for minimally invasive spleen-preserving distal pancreatectomy, either laparoscopically or robotically assisted. The aim of this study was to establish benchmarks for these techniques using two different methods.MethodsData from patients undergoing laparoscopically or robotically assisted spleen-preserving distal pancreatectomy were extracted from a multicentre database (2006-2019). Benchmarks for 10 outcomes were calculated using the Achievable Benchmark of Care (ABC) and best-patient-in-best-centre methods.ResultsOverall, 951 laparoscopically assisted (77.3 per cent) and 279 robotically assisted (22.7 per cent) procedures were included. Using the ABC method, the benchmarks for laparoscopically assisted and robotically assisted spleen-preserving distal pancreatectomy respectively were: 150 and 207 min for duration of operation, 55 and 100 ml for blood loss, 3.5 and 1.7 per cent for conversion, 0 and 1.7 per cent for failure to preserve the spleen, 27.3 and 34.0 per cent for overall morbidity, 5.1 and 3.3 per cent for major morbidity, 3.6 and 7.1 per cent for pancreatic fistula grade B/C, 5 and 6 days for duration of hospital stay, 2.9 and 5.4 per cent for readmissions, and 0 and 0 per cent for 90-day mortality. Best-patient-in-best-centre methodology revealed milder benchmark cut-offs for laparoscopically and robotically assisted procedures, with operating times of 254 and 262.5 min, blood loss of 150 and 195 ml, conversion rates of 5.8 and 8.2 per cent, rates of failure to salvage spleen of 29.9 and 27.3 per cent, overall morbidity rates of 62.7 and 55.7 per cent, major morbidity rates of 20.4 and 14 per cent, POPF B/C rates of 23.8 and 24.2 per cent, duration of hospital stay of 8 and 8 days, readmission rates of 20 and 15.1 per cent, and 90-day mortality rates of 0 and 0 per cent respectively.ConclusionTwo benchmark methods for minimally invasive distal pancreatectomy produced different values, and should be interpreted and applied differently.© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.

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