ArticleSurgical endoscopy2021
Evaluation of a single surgeon's learning curve of laparoscopic pancreaticoduodenectomy: risk-adjusted cumulative summation analysis.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Learning curves in minimally invasive pancreatic surgery: a systematic review.Langenbeck's archives of surgery · 2022Pooled it
- Institutional learning curve for robotic pancreatoduodenectomy: a consecutive 100-case analysis.Surgical endoscopy · 2026Article
- Learning curve and perioperative outcomes of robotic-assisted distal pancreatectomy: a single-center study.Journal of robotic surgery · 2025Article
- Virtual 3D models, augmented reality systems and virtual laparoscopic simulations in complicated pancreatic surgeries: state of art, future perspectives, and challenges.International journal of surgery (London, England) · 2025Review
- Role of haptic feedback technologies and novel engineering developments for surgical training and robot-assisted surgery.Frontiers in robotics and AI · 2025Review
- Perioperative outcomes of robot-assisted pancreatoduodenectomy (PD) and totally laparoscopic PD after overcoming learning curves with comparison of oncologic outcomes between open PD and minimally invasive PD.Annals of hepato-biliary-pancreatic surgery · 2024Article
- Article
- Learning curve of robotic pancreatoduodenectomy by a single surgeon with extensive laparoscopic pancreatoduodenectomy experience.Journal of robotic surgery · 2024Article
- Analysis of the learning curve for laparoscopic pancreaticoduodenectomy based on a single surgeon's experience: a retrospective observational study.Annals of surgical treatment and research · 2024Article
- Radiological classification of the Heidelberg triangle and its application in laparoscopic pancreaticoduodenectomy for malignancies.World journal of surgical oncology · 2024Article
- The learning curve for laparoscopic pancreaticoduodenectomy by a proficient laparoscopic surgeon: a retrospective study at a single center.BMC surgery · 2024Article
- Cumulative summation analysis of learning curve for endoscopic endonasal transsphenoidal resection of craniopharyngiomas.Frontiers in surgery · 2024Article
- Learning curve of laparoscopic cholecystectomy: a risk-adjusted cumulative summation (RA-CUSUM) analysis of six general surgery residents.Surgical endoscopy · 2023Article
- Glucose Regulation after Partial Pancreatectomy: A Comparison of Pancreaticoduodenectomy and Distal Pancreatectomy in the Short and Long Term.Diabetes & metabolism journal · 2023Observational
- First assistant experience in total laparoscopic pancreaticoduodenectomy: accelerating the learning curve for an operator.BMC surgery · 2023Article
- Learning curve of robotic rectal surgery using risk-adjusted cumulative summation: a 5-year institutional experience.Langenbeck's archives of surgery · 2023Article
- The long-term outcomes of laparoscopic versus open pancreatoduodenectomy for ampullary carcinoma showed similar survival: a case-matched comparative study.Surgical endoscopy · 2022Article
- Article
- Minimally Invasive Pancreaticoduodenectomy: Similar Morbidity and No Mortality in the Learning Period.Sisli Etfal Hastanesi tip bulteni · 2022Article
- The Road to Technical Proficiency in Cytoreductive Surgery for Peritoneal Carcinomatosis: Risk-Adjusted Cumulative Summation Analysis.Frontiers in surgery · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic pancreaticoduodenectomy (LPD) is technically demanding and there is much controversy about its safety. We evaluated the learning curve for pure LPD based on the clinical outcomes of consecutive patients treated by a single surgeon.
methodsWe reviewed the medical records of 119 consecutive patients who underwent LPD by a single surgeon between June 2013 and August 2018. The learning curve was evaluated using the cumulative summation (CUSUM) and risk-adjusted CUSUM (RA-CUSUM) methods. Perioperative outcomes were compared among the learning curve phases.
resultsCUSUM analysis of the operation time showed that the operation time improved after the 47th case. RA-CUSUM analysis showed the learning curve for surgical failure, defined as severe complications (Clavien-Dindo grade ≥ 3) or open conversion, comprised three phases (phase 1: cases 1-60; phase 2: cases 61-83; phase 3: cases 84-119). There were no significant differences in operation time among the three phases. Intraoperative blood loss decreased significantly over the three phases (P = 0.032). There were no postoperative deaths. The rates of postoperative complications, pancreatic fistula (grade B/C), and post-pancreatic hemorrhage were significantly lower in phase 3 than in phase 2 (2.8% vs. 21.7%, P = 0.019; 2.8% vs. 17.4%, P = 0.049; 0% vs. 13.0%, P = 0.026), but not between phases 1 and 2. Postoperative hospital stay decreased progressively, and was significantly shorter in phase 3 than in phase 1 (9.1 vs. 16.7 days, P = 0.001).
conclusionsThe LPD failure rate decreased after the first 60 cases and stabilized after 84 cases. For safe dissemination of LPD, it is important to shorten the long learning curve and decrease the unfavorable outcomes in the early phase of the learning curve.
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