Portal de investigación
Incidence, Causes, and Outcomes of Conversion to Open Surgery During Minimally Invasive Left Pancreatectomy: A Prospective Multicenter Study.
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- C V
- B HR
- Jj RG
- Busquets J
- Secanella L
- Peláez N
- Alkorta M
- De Ariño Hervas I
- Achalandabaso MM
- Toledo E
- Rotellar F
- Martí-Cruchaga P
- Gómez-Bravo MÁ
- Suárez G
- Garcés-Albir M
- Sabater L
- Alcalá FJ
- Asensio E
- Pacheco D
- Cugat E
- Espín F
- Galófre M
- Sánchez B
- Santoyo J
- Loinaz C
- Sánchez-Cabús S
- Martín B
- Blanco G
- Jaén-Torrejimeno I
- Domingo C
- Payá C
- Ruiz S
- Vico AB
- Zambudio N
- Estévez S
- Nogueira-Sixto M
- Miota JI
- Conde B
- Suárez MÁ
- Rúa JR
- González M
- González PE
- Reyes B
- Ben SL
- Tió B
- Mínguez J
- Lasa I
- Miyar A
- Solar L
- Burdio F
- Ielpo B
- Carabias A
- Paloma M
- Escartín A
- Vela F
- Marqués E
- Pérez A
- Palomares G
- Castell JT
- Castro MJ
- Manzanares MC
- Artigues E
- Blas JL
- Díez L
- Calero A
- Quiñones JE
- Rodríguez M
- Serradilla-Martín M
- Alcázar C
- Jm R
Grupos
Abstract
BACKGROUND: Minimally invasive left pancreatectomy (MILP) has become the preferred approach to treat lesions of the pancreatic body and tail. However, the procedure may require conversion to open surgery, with reported conversion rates varying widely in the literature. This study aims to evaluate the incidence, causes, and clinical outcomes associated with conversion to open surgery in a prospective multicenter series. METHODS: The SPANDISPAN Project is a prospective, multicenter study conducted at 41 Spanish hospitals from February 2022 to January 2023. Patients were divided into conversion and nonconversion groups to identify predictors using univariate and multivariate logistic regression models. RESULTS: Of 313 recorded left pancreatectomies, 217 (69.3%) were MILP procedures. The conversion rate was 10.6%. Reasons for conversion included hemorrhage (60.9%) and intraoperative technical difficulties (39.1%). Multivariable analysis identified intraoperative blood loss (OR 1.65 per 100-mL increment; p < 0.001) and intraoperative transfusion (OR 7.777; p = 0.012) as independent intraoperative correlates of conversion, reflecting the bleeding-related process leading to conversion rather than preoperative predictors available for case selection. Low center volume was associated with a higher conversion rate in univariable analysis (14.5% vs. 6%; p = 0.042) with a nonsignificant protective trend for high-volume centers after multivariable adjustment (OR 0.339; p = 0.075). Although patients who required conversion had longer operative times and hospital stays, there were no significant differences in major complications, postoperative pancreatic fistula, or mortality between the groups. CONCLUSIONS: Conversion to open surgery during MILP is primarily driven by intraoperative bleeding-related events rather than by preoperative patient or tumor characteristics. Treatment at a high-volume center was associated with a lower conversion rate, although this trend did not reach significance after multivariable adjustment. Conversion was not associated with a significant increase in major morbidity or mortality in this cohort, supporting its use as a proactive safety measure rather than a surgical failure, although the limited number of conversion events warrants a cautious interpretation of this negative finding.
© 2026 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC). All rights reserved, including rights for text and data mining and training of artificial intelligence technologies or similar technologies.
Datos de la publicación
- ISSN/ISSNe:
- 0364-2313, 1432-2323
- Tipo:
- Article
- Páginas:
- -
- DOI:
- 10.1002/wjs.70531
- PubMed:
- 42631535
WORLD JOURNAL OF SURGERY WILEY
Documentos
- No hay documentos
Filiaciones
Keywords
- conversion; minimally invasive surgery; pancreas; risk factors
Cita
Gomez I,CV,BHR,JJRG,Busquets J,Secanella L,Peláez N,Alkorta M,De Ariño I,Achalandabaso MM,Toledo E,Rotellar F,Martí P,Gómez MÁ,Suárez G,Garcés M,Sabater L,García G,Alcalá FJ,Asensio E,Pacheco D,Cugat E,Espín F,Galófre M,Sánchez B,Santoyo J,Calvo J,Loinaz C,García M,Sánchez S,Martín B,Blanco G,Jaén I,Domingo C,Payá C,González C,Ruiz S,LÓPEZ R,BALLESTER C,Vico AB,Zambudio N,Estévez S,Nogueira M,Miota JI,Conde B,Suárez MÁ,Rúa JR,Blanco A,González M,González PE,Reyes B,Ben SL,Tió B,Mínguez J,Lasa I,Miyar A,Solar L,Burdio F,Ielpo B,Carabias A,Paloma M,Escartín A,Vela F,Marqués E,Pérez A,Palomares G,Calvo A,Castell JT,Castro MJ,Manzanares MC,Artigues E,Blas JL,Díez L,Calero A,Quiñones JE,Rodríguez M,Serradilla M,Alcázar C,JMR. Incidence, Causes, and Outcomes of Conversion to Open Surgery During Minimally Invasive Left Pancreatectomy: A Prospective Multicenter Study. World J Surg. 2026. IF:2,200. (2).