PROTOCOL
OBJECTIVE
To conduct a retrospective multicenter cohort study to define benchmark values for best achievable outcomes following minimal invasive pancreatoduodenectomies (MIPD).
POLICY SECURING
Confidential center specific data: No center-specific data will be published. Instead, all complications or adverse outcomes will be anonymously reported, as fractions of the total study population. Each center, of course, will be free to publish their own data, as they wish.
Authorship: No data will be submitted or published without authorization from each participating center. Each center will be represented by its contributors including two co-authorships per center.
In the ideal case there will be one junior author who will coordinate data collection with Prof. Dr. Felix Nickel (Principal investigator and coordinator of the study from Hamburg) and Yue Wang (coordinator and surgical resident from Hamburg).
Further use of cohort data: Future studies based on the collected data will hopefully emerge from this multicenter study and will only be conducted with authorization from each participating center.
METHODS
Benchmark Values:
- Mortality 30 and 90 days
- Morbidity
- Complication grading according to Clavien-Dindo (Dindo et al., Ann Surg, 2004)
- Complication quantification with the Comprehensive Complication Index CCI (Slankamenac et al., Ann Surg, 2013)
- Pancreas specific complications (POPF, DGE, PPH, BL, CL, PPAP)
- Re-Operation, Re-Intervention
- Operation characteristics
- Duration of surgery
- Blood loss
- R0 resection
- Number of harvested lymph nodes
- Conversion to open surgery
- Length of stay (ICU), length of stay (hospital)
- Readmission
- Disease free survival (DFS) and Overall survival (OS) (reported at one and 3 years) for malignant indications
Study period:
- 06/2003 – 02/2025
Center eligibility:
- Minimum of 50 annual pancreatic procedures per center
- Prospective database available with a minimum of 50 RPDs and/or 50 LPDs
Patient eligibility (benchmark cases criteria):
Please note that, at this stage, the study will include all consecutive MIPD cases (benchmark and non-benchmark cases).
Inclusion criteria:
- Adults ≥ 18 years
- RPD (any indication) or LPD (any indication)
Exclusion criteria:
- Primary open procedures
- MIPD in emergency setting
GOVERNANCE
Data will be collected via a secure; password protected, and encrypted online data management system with server location in Europe (Switzerland). This platform uses a data entry management system (DEMS) to meet international standards for online databases including fully anonymous data and the data is fully protected according the “EU-Datenschutzgrundverordnung” (DSGVO). Data will not be published with hospital identifiers.
DATA COLLECTION
Local collaborators: Most hospitals will have two local investigators; a senior and a junior investigator. The junior collaborator will be in regular contact with the principal investigator and study coordinators in Hamburg (Prof. Dr. Felix Nickel and Yue Wang). The junior investigator will be responsible for:
- Gaining local research ethics approval
- Identifying and including all eligible patients
- Accurately collecting baseline and follow-up data
- Submission of data to the online DEMS database