Evidence map›Paper›PMID 31529332›Full record

ArticleWorld journal of surgery2019

Critical Appraisal of the Impact of the Systematic Adoption of Advanced Minimally Invasive Hepatobiliary and Pancreatic Surgery on the Surgical Management of Mirizzi Syndrome.

Ye-Xin Koh, Pallavi Basu, Yi-Xin Liew, Jin-Yao Teo, Juinn-Huar Kam, Ser-Yee Lee, Peng-Chung Cheow, Premaraj Jeyaraj, Pierce K H Chow, Alexander Y F Chung and 3 more

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Article in World journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Ye-Xin KohDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Pallavi BasuDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Yi-Xin LiewDepartment of Pharmacy, Singapore General Hospital, Singapore, 169856, Singapore.
Jin-Yao TeoDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Juinn-Huar KamDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Ser-Yee LeeDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Peng-Chung CheowDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Premaraj JeyarajDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Pierce K H ChowDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Alexander Y F ChungDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
London L P J OoiDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Chung-Yip ChanDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Brian K P GohDepartment of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore. bsgkp@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinimally 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.

methodsNinety-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).

resultsComparison 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).

conclusionsSystematic 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.

Indexed as

AdultAgedDigestive System Surgical ProceduresFemaleHumansLength of StayMaleMiddle AgedMinimally Invasive Surgical ProceduresMirizzi SyndromeRetrospective Studies

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.