Minimally Invasive Distal Pancreatectomy as the Standard of Care in the US: Are We There Yet?

作者：Laleh Foroutani, Andrew A. Gonzalez, Jane Wang, Bahaa I. Aburayya, Amir Ashraf‐Ganjouei, Jean Feng, Lucas W. Thornblade, Kenzo Hirose, Ajay V. Maker, Eric K. Nakakura, Carlos U. Corvera, Adnan Alseidi, Mohamed A. Adam · 发表于：Cancers · 年份：2025 · DOI：10.3390/cancers17183015 · 被引用次数：6 · 研究领域：Pancreatic and Hepatic Oncology Research、Surgical Simulation and Training、Pancreatitis Pathology and Treatment

Introduction: While there is an increasing shift towards minimally invasive distal pancreatectomy (MIDP), little is known about how utilization of MIDP vs. open distal pancreatectomy (ODP) has evolved over time. We aimed to determine competing temporal trends in use and outcomes of MIDP (laparoscopic and robotic) over time and to determine if a threshold of effectiveness has been reached. Methods: Adults undergoing MIDP and ODP were identified from the National Cancer Database (2010–2021) and the National Surgical Quality Improvement Program database (2014–2022). Propensity score matching (PSM) was performed to address baseline differences between groups before comparing outcomes. Joinpoint regression analysis (JRA) was employed to assess adjusted trends in adoption and outcomes. We calculated Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC) to quantify yearly adoption rates and their trends, respectively. Results: Among 21,966 patients in the NCDB cohort, 49.5% underwent MIDP, including 33.7% laparoscopic distal pancreatectomy (LDP) and 15.8% robotic distal pancreatectomy (RDP), while 50.5% underwent ODP. ODP declined from 74.1% of cases (2010) to 41.1% (2021), with an AAPC of −4.9%. MIDP increased significantly throughout the study from 25.9% of cases (2010) to 58.9% (2021), with an AAPC of 6.3%. Among MIDP subgroups, there was an initial increase in LDP until 2016, after which its rate of utilization stagnated with an AAPC of 0.7% (p > 0.05). I...