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Critical Appraisal of the Impact of the Systematic Adoption of Advanced Minimally Invasive Hepatobiliary and Pancreatic Surgery on the Surgical Management of Mirizzi Syndrome
Background Minimally invasive surgery (MIS) for Mirizzi syndrome (MS) remains a technically challenging procedure with a high open conversion rate. We critically evaluated the impact of the systematic adoption of MI-HBP surgery on the surgical outcomes of MS. Methods Ninety-five patients who underwe...
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| Published in: | World journal of surgery 2019-12, Vol.43 (12), p.3138-3152 |
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| container_end_page | 3152 |
| container_issue | 12 |
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| container_title | World journal of surgery |
| container_volume | 43 |
| creator | Koh, Ye-Xin Basu, Pallavi Liew, Yi-Xin Teo, Jin-Yao Kam, Juinn-Huar Lee, Ser-Yee Cheow, Peng-Chung Jeyaraj, Premaraj Chow, Pierce K. H. Chung, Alexander Y. F. Ooi, London L. P. J. Chan, Chung-Yip Goh, Brian K. P. |
| description | Background
Minimally invasive surgery (MIS) for Mirizzi syndrome (MS) remains a technically challenging procedure with a high open conversion rate. We critically evaluated the impact of the systematic adoption of MI-HBP surgery on the surgical outcomes of MS.
Methods
Ninety-five patients who underwent surgery for MS were retrospectively reviewed. Systematic adoption of advanced MI-HBP surgery started in 2012. The cohort was classified into a preadoption (2002–2012) (Era 1,
n
= 58) and post-adoption (2013–2017) (Era 2,
n
= 37). Furthermore, Era 2 was divided into a cohort operated by advanced minimally invasive surgeons (AMIS) (Era 2 AMIS,
n
= 19) and those by other surgeons (Era 2 others,
n
= 19).
Results
Comparison between Era 2 and Era 1 demonstrated a significant increase in the frequency of MIS attempted (89% vs 33%,
p |
| doi_str_mv | 10.1007/s00268-019-05164-y |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2293003575</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2293003575</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4039-a5a699e017c1ce69af08eb3f3dc527f22ccbf6421f8bfface092fe8e74bc319d3</originalsourceid><addsrcrecordid>eNqNUUtv1DAQjhBILIU_wCkSFy4BP_Iyt2XV0kVdFWlBHC3HGRdXiR3s7KL0R_EbmU2oKnFAPdkz_h7j-ZLkNSXvKCHV-0gIK-uMUJGRgpZ5Nj1JVjTnLGOc8afJinBsMk758-RFjLeE0Kok5Sr5vQl2tFp16XoYgrIRb96k4w9It_2g9Hhf7ac4Qq8Qm65bP4zWu9PTuj0qp6FNd9bZXnXdlG7dUUV7hPQSBjX6xnZWhSlVrk2_IDbALLI_hBvANsrM8ljOY-yUUzfQg5uddzbYuzuL7q4NvoeXyTOjugiv_p5nybeL86-by-zq-tN2s77KdE64yFShSiEAP6mphlIoQ2pouOGtLlhlGNO6MWXOqKkbY5QGIpiBGqq80ZyKlp8lbxfdIfifB4ij7G3U0HXKgT9EyZjghPCiKhD65h_orT8Eh9OdUJRiCrVAFFtQOvgYAxg5BNxXmCQl8hShXCKUGKGcI5QTkj4spF-2g-kRDPn98_7jBYZbnhz5Qo7Ic7jrh7n-Y_kHUGa0ew</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2291114389</pqid></control><display><type>article</type><title>Critical Appraisal of the Impact of the Systematic Adoption of Advanced Minimally Invasive Hepatobiliary and Pancreatic Surgery on the Surgical Management of Mirizzi Syndrome</title><source>Springer Nature</source><creator>Koh, Ye-Xin ; Basu, Pallavi ; Liew, Yi-Xin ; Teo, Jin-Yao ; Kam, Juinn-Huar ; Lee, Ser-Yee ; Cheow, Peng-Chung ; Jeyaraj, Premaraj ; Chow, Pierce K. H. ; Chung, Alexander Y. F. ; Ooi, London L. P. J. ; Chan, Chung-Yip ; Goh, Brian K. P.</creator><creatorcontrib>Koh, Ye-Xin ; Basu, Pallavi ; Liew, Yi-Xin ; Teo, Jin-Yao ; Kam, Juinn-Huar ; Lee, Ser-Yee ; Cheow, Peng-Chung ; Jeyaraj, Premaraj ; Chow, Pierce K. H. ; Chung, Alexander Y. F. ; Ooi, London L. P. J. ; Chan, Chung-Yip ; Goh, Brian K. P.</creatorcontrib><description>Background
Minimally invasive surgery (MIS) for Mirizzi syndrome (MS) remains a technically challenging procedure with a high open conversion rate. We critically evaluated the impact of the systematic adoption of MI-HBP surgery on the surgical outcomes of MS.
Methods
Ninety-five patients who underwent surgery for MS were retrospectively reviewed. Systematic adoption of advanced MI-HBP surgery started in 2012. The cohort was classified into a preadoption (2002–2012) (Era 1,
n
= 58) and post-adoption (2013–2017) (Era 2,
n
= 37). Furthermore, Era 2 was divided into a cohort operated by advanced minimally invasive surgeons (AMIS) (Era 2 AMIS,
n
= 19) and those by other surgeons (Era 2 others,
n
= 19).
Results
Comparison between Era 2 and Era 1 demonstrated a significant increase in the frequency of MIS attempted (89% vs 33%,
p
< 0.01), increase in the use of choledochoplasty (24% vs 2%,
p
< 0.01), increase operation time (180 min vs 150 min,
p
= 0.03) and significantly lower open conversion rate (24% vs 58%,
p
< 0.01). Comparison between Era 2 AMIS and Era 2 others demonstrated a significantly greater adoption of MIS (100% vs 78%,
p
= 0.046) with lower open conversion rate (5% vs 50%,
p
= 0.005). Comparison between all attempted MIS cases with open procedures demonstrated a significantly higher proportion of subtotal cholecystectomies performed (40% vs 23%,
p
= 0.04), choledochoplasty (17% vs 2%,
p
= 0.04) and shorter hospital stay (4 days vs 9 days,
p
< 0.01).
Conclusions
Systematic adoption of advanced MI-HBP surgery allowed surgeons to perform MIS for MS more frequently and with a significantly lower open conversion rate. Patients who underwent successful MIS had the shortest hospital stay compared to patients who underwent open surgery or required open conversion.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-019-05164-y</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Cardiac Surgery ; Conversion ; General Surgery ; Medical personnel ; Medicine ; Medicine & Public Health ; Minimally invasive surgery ; Original Scientific Report ; Pancreas ; Patients ; Surgeons ; Surgery ; Surgical outcomes ; Thoracic Surgery ; Vascular Surgery</subject><ispartof>World journal of surgery, 2019-12, Vol.43 (12), p.3138-3152</ispartof><rights>Société Internationale de Chirurgie 2019</rights><rights>2019 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4039-a5a699e017c1ce69af08eb3f3dc527f22ccbf6421f8bfface092fe8e74bc319d3</citedby><cites>FETCH-LOGICAL-c4039-a5a699e017c1ce69af08eb3f3dc527f22ccbf6421f8bfface092fe8e74bc319d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Koh, Ye-Xin</creatorcontrib><creatorcontrib>Basu, Pallavi</creatorcontrib><creatorcontrib>Liew, Yi-Xin</creatorcontrib><creatorcontrib>Teo, Jin-Yao</creatorcontrib><creatorcontrib>Kam, Juinn-Huar</creatorcontrib><creatorcontrib>Lee, Ser-Yee</creatorcontrib><creatorcontrib>Cheow, Peng-Chung</creatorcontrib><creatorcontrib>Jeyaraj, Premaraj</creatorcontrib><creatorcontrib>Chow, Pierce K. H.</creatorcontrib><creatorcontrib>Chung, Alexander Y. F.</creatorcontrib><creatorcontrib>Ooi, London L. P. J.</creatorcontrib><creatorcontrib>Chan, Chung-Yip</creatorcontrib><creatorcontrib>Goh, Brian K. P.</creatorcontrib><title>Critical Appraisal of the Impact of the Systematic Adoption of Advanced Minimally Invasive Hepatobiliary and Pancreatic Surgery on the Surgical Management of Mirizzi Syndrome</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><description>Background
Minimally invasive surgery (MIS) for Mirizzi syndrome (MS) remains a technically challenging procedure with a high open conversion rate. We critically evaluated the impact of the systematic adoption of MI-HBP surgery on the surgical outcomes of MS.
Methods
Ninety-five patients who underwent surgery for MS were retrospectively reviewed. Systematic adoption of advanced MI-HBP surgery started in 2012. The cohort was classified into a preadoption (2002–2012) (Era 1,
n
= 58) and post-adoption (2013–2017) (Era 2,
n
= 37). Furthermore, Era 2 was divided into a cohort operated by advanced minimally invasive surgeons (AMIS) (Era 2 AMIS,
n
= 19) and those by other surgeons (Era 2 others,
n
= 19).
Results
Comparison between Era 2 and Era 1 demonstrated a significant increase in the frequency of MIS attempted (89% vs 33%,
p
< 0.01), increase in the use of choledochoplasty (24% vs 2%,
p
< 0.01), increase operation time (180 min vs 150 min,
p
= 0.03) and significantly lower open conversion rate (24% vs 58%,
p
< 0.01). Comparison between Era 2 AMIS and Era 2 others demonstrated a significantly greater adoption of MIS (100% vs 78%,
p
= 0.046) with lower open conversion rate (5% vs 50%,
p
= 0.005). Comparison between all attempted MIS cases with open procedures demonstrated a significantly higher proportion of subtotal cholecystectomies performed (40% vs 23%,
p
= 0.04), choledochoplasty (17% vs 2%,
p
= 0.04) and shorter hospital stay (4 days vs 9 days,
p
< 0.01).
Conclusions
Systematic adoption of advanced MI-HBP surgery allowed surgeons to perform MIS for MS more frequently and with a significantly lower open conversion rate. Patients who underwent successful MIS had the shortest hospital stay compared to patients who underwent open surgery or required open conversion.</description><subject>Abdominal Surgery</subject><subject>Cardiac Surgery</subject><subject>Conversion</subject><subject>General Surgery</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minimally invasive surgery</subject><subject>Original Scientific Report</subject><subject>Pancreas</subject><subject>Patients</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqNUUtv1DAQjhBILIU_wCkSFy4BP_Iyt2XV0kVdFWlBHC3HGRdXiR3s7KL0R_EbmU2oKnFAPdkz_h7j-ZLkNSXvKCHV-0gIK-uMUJGRgpZ5Nj1JVjTnLGOc8afJinBsMk758-RFjLeE0Kok5Sr5vQl2tFp16XoYgrIRb96k4w9It_2g9Hhf7ac4Qq8Qm65bP4zWu9PTuj0qp6FNd9bZXnXdlG7dUUV7hPQSBjX6xnZWhSlVrk2_IDbALLI_hBvANsrM8ljOY-yUUzfQg5uddzbYuzuL7q4NvoeXyTOjugiv_p5nybeL86-by-zq-tN2s77KdE64yFShSiEAP6mphlIoQ2pouOGtLlhlGNO6MWXOqKkbY5QGIpiBGqq80ZyKlp8lbxfdIfifB4ij7G3U0HXKgT9EyZjghPCiKhD65h_orT8Eh9OdUJRiCrVAFFtQOvgYAxg5BNxXmCQl8hShXCKUGKGcI5QTkj4spF-2g-kRDPn98_7jBYZbnhz5Qo7Ic7jrh7n-Y_kHUGa0ew</recordid><startdate>201912</startdate><enddate>201912</enddate><creator>Koh, Ye-Xin</creator><creator>Basu, Pallavi</creator><creator>Liew, Yi-Xin</creator><creator>Teo, Jin-Yao</creator><creator>Kam, Juinn-Huar</creator><creator>Lee, Ser-Yee</creator><creator>Cheow, Peng-Chung</creator><creator>Jeyaraj, Premaraj</creator><creator>Chow, Pierce K. H.</creator><creator>Chung, Alexander Y. F.</creator><creator>Ooi, London L. P. J.</creator><creator>Chan, Chung-Yip</creator><creator>Goh, Brian K. P.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201912</creationdate><title>Critical Appraisal of the Impact of the Systematic Adoption of Advanced Minimally Invasive Hepatobiliary and Pancreatic Surgery on the Surgical Management of Mirizzi Syndrome</title><author>Koh, Ye-Xin ; Basu, Pallavi ; Liew, Yi-Xin ; Teo, Jin-Yao ; Kam, Juinn-Huar ; Lee, Ser-Yee ; Cheow, Peng-Chung ; Jeyaraj, Premaraj ; Chow, Pierce K. H. ; Chung, Alexander Y. F. ; Ooi, London L. P. J. ; Chan, Chung-Yip ; Goh, Brian K. P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4039-a5a699e017c1ce69af08eb3f3dc527f22ccbf6421f8bfface092fe8e74bc319d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Cardiac Surgery</topic><topic>Conversion</topic><topic>General Surgery</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Minimally invasive surgery</topic><topic>Original Scientific Report</topic><topic>Pancreas</topic><topic>Patients</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koh, Ye-Xin</creatorcontrib><creatorcontrib>Basu, Pallavi</creatorcontrib><creatorcontrib>Liew, Yi-Xin</creatorcontrib><creatorcontrib>Teo, Jin-Yao</creatorcontrib><creatorcontrib>Kam, Juinn-Huar</creatorcontrib><creatorcontrib>Lee, Ser-Yee</creatorcontrib><creatorcontrib>Cheow, Peng-Chung</creatorcontrib><creatorcontrib>Jeyaraj, Premaraj</creatorcontrib><creatorcontrib>Chow, Pierce K. H.</creatorcontrib><creatorcontrib>Chung, Alexander Y. F.</creatorcontrib><creatorcontrib>Ooi, London L. P. J.</creatorcontrib><creatorcontrib>Chan, Chung-Yip</creatorcontrib><creatorcontrib>Goh, Brian K. P.</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koh, Ye-Xin</au><au>Basu, Pallavi</au><au>Liew, Yi-Xin</au><au>Teo, Jin-Yao</au><au>Kam, Juinn-Huar</au><au>Lee, Ser-Yee</au><au>Cheow, Peng-Chung</au><au>Jeyaraj, Premaraj</au><au>Chow, Pierce K. H.</au><au>Chung, Alexander Y. F.</au><au>Ooi, London L. P. J.</au><au>Chan, Chung-Yip</au><au>Goh, Brian K. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Critical Appraisal of the Impact of the Systematic Adoption of Advanced Minimally Invasive Hepatobiliary and Pancreatic Surgery on the Surgical Management of Mirizzi Syndrome</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><date>2019-12</date><risdate>2019</risdate><volume>43</volume><issue>12</issue><spage>3138</spage><epage>3152</epage><pages>3138-3152</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
Minimally invasive surgery (MIS) for Mirizzi syndrome (MS) remains a technically challenging procedure with a high open conversion rate. We critically evaluated the impact of the systematic adoption of MI-HBP surgery on the surgical outcomes of MS.
Methods
Ninety-five patients who underwent surgery for MS were retrospectively reviewed. Systematic adoption of advanced MI-HBP surgery started in 2012. The cohort was classified into a preadoption (2002–2012) (Era 1,
n
= 58) and post-adoption (2013–2017) (Era 2,
n
= 37). Furthermore, Era 2 was divided into a cohort operated by advanced minimally invasive surgeons (AMIS) (Era 2 AMIS,
n
= 19) and those by other surgeons (Era 2 others,
n
= 19).
Results
Comparison between Era 2 and Era 1 demonstrated a significant increase in the frequency of MIS attempted (89% vs 33%,
p
< 0.01), increase in the use of choledochoplasty (24% vs 2%,
p
< 0.01), increase operation time (180 min vs 150 min,
p
= 0.03) and significantly lower open conversion rate (24% vs 58%,
p
< 0.01). Comparison between Era 2 AMIS and Era 2 others demonstrated a significantly greater adoption of MIS (100% vs 78%,
p
= 0.046) with lower open conversion rate (5% vs 50%,
p
= 0.005). Comparison between all attempted MIS cases with open procedures demonstrated a significantly higher proportion of subtotal cholecystectomies performed (40% vs 23%,
p
= 0.04), choledochoplasty (17% vs 2%,
p
= 0.04) and shorter hospital stay (4 days vs 9 days,
p
< 0.01).
Conclusions
Systematic adoption of advanced MI-HBP surgery allowed surgeons to perform MIS for MS more frequently and with a significantly lower open conversion rate. Patients who underwent successful MIS had the shortest hospital stay compared to patients who underwent open surgery or required open conversion.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1007/s00268-019-05164-y</doi><tpages>15</tpages></addata></record> |
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| ispartof | World journal of surgery, 2019-12, Vol.43 (12), p.3138-3152 |
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| language | eng |
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| source | Springer Nature |
| subjects | Abdominal Surgery Cardiac Surgery Conversion General Surgery Medical personnel Medicine Medicine & Public Health Minimally invasive surgery Original Scientific Report Pancreas Patients Surgeons Surgery Surgical outcomes Thoracic Surgery Vascular Surgery |
| title | Critical Appraisal of the Impact of the Systematic Adoption of Advanced Minimally Invasive Hepatobiliary and Pancreatic Surgery on the Surgical Management of Mirizzi Syndrome |
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