Detailed Abstract
[BP Poster Presentation 5 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP PP 5-1] A Learning Curve Analysis Of Laparoscopic Pancreaticoduodenectomy By A Single Surgeon
Hee Joon KIM*1 , Sang Hoon SHIN1
1 Division Of HBP Surgery, Department Of Surgery, Chonnam National University Medical School, REPUBLIC OF KOREA
Background : Laparoscopic Pancreaticoduodenectomy (LPD) is one of the most challenging procedures. The aim of this study is to analyze the learning curve of LPD based on a single surgeon’s experience.
Methods : The medical records of 111 consecutive patients who underwent LPD by a single surgeon between March 2014 and October 2022 were analyzed retrospectively. The learning curve was evaluated using the cumulative summation (CUSUM) and risk-adjusted CUSUM (RA-CUSUM) methods. Surgical failure was defined as open conversion, and severe complication (Clavian-Dindo grade ≥ 3). Early and late phases were classified along the result of the learning curve analysis, and the operative outcomes of each phase were compared.
Results : In a CUSUM analysis for operation time, the operation time decreased after the first 33 cases. As a result of the RA-CUSUM analysis, the LPD technique was stabilized after the 44th case. The operation time, length of stay, rate of delayed gastric emptying, severe complication, and surgical failure in the late phase were significantly lower than in the early phase.
Conclusions : For stabilization of the LPD technique and operative outcomes, 44 cases are required.
Methods : The medical records of 111 consecutive patients who underwent LPD by a single surgeon between March 2014 and October 2022 were analyzed retrospectively. The learning curve was evaluated using the cumulative summation (CUSUM) and risk-adjusted CUSUM (RA-CUSUM) methods. Surgical failure was defined as open conversion, and severe complication (Clavian-Dindo grade ≥ 3). Early and late phases were classified along the result of the learning curve analysis, and the operative outcomes of each phase were compared.
Results : In a CUSUM analysis for operation time, the operation time decreased after the first 33 cases. As a result of the RA-CUSUM analysis, the LPD technique was stabilized after the 44th case. The operation time, length of stay, rate of delayed gastric emptying, severe complication, and surgical failure in the late phase were significantly lower than in the early phase.
Conclusions : For stabilization of the LPD technique and operative outcomes, 44 cases are required.
SESSION
BP Poster Presentation 5
Poster Presentation 3/24/2023 2:50 PM - 3:50 PM