Journal article
The São Paulo International Consensus on Minimally Invasive Pancreatic Surgery for Cancer
HPB (Oxford, England), Vol.28(2), pp.105-118
02/2026
DOI: 10.1016/j.hpb.2025.11.012
PMID: 41419350
Abstract
Although minimally invasive surgery is widely accepted across surgical disciplines, its role in pancreatic cancer continues to be debated. The objective of the São Paulo Consensus on Minimally Invasive Pancreas Surgery (MIPS) was to establish consensus statements on the use of MIPS for pancreatic cancer, integrating contemporary evidence and recent advances.
A scoping literature review informed statement development across five thematic groups: (1) Left Pancreatectomy for Pancreatic Cancer, (2) Pancreatoduodenectomy and Total Pancreatectomy for Pancreatic Cancer, (3) Neuroendocrine Pancreatic Tumors, (4) Patient Evaluation and Surgical Technique, and (5) Implementation, Training, and Innovation. A three-round modified Delphi process was conducted with an international panel of 52 expert pancreas surgeons. Consensus was defined as ≥90% agreement.
From 2,590 publications, 185 studies were selected for inclusion. Fifty-two hepatopancreatobiliary surgeons, with a median of 22 years of experience, achieved consensus through a three-round Delphi process. Ultimately, 22 of the initial 28 statements met the ≥90% agreement threshold. The resulting recommendations provide evidence-based guidance on minimally invasive pancreas resection for cancer, neuroendocrine tumors, patient evaluation, program implementation, and innovation.
The São Paulo Consensus provides contemporary, evidence-based recommendations to guide the safe and judicious adoption, implementation, and practice of minimally invasive techniques.
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Details
- Title: Subtitle
- The São Paulo International Consensus on Minimally Invasive Pancreatic Surgery for Cancer
- Creators
- Francisco Tustumi - Universidade de São PauloLucia Calthorpe - University of California, San FranciscoNora Fotoohi - University of California, San FranciscoThiago Costa Ribeiro - Universidade de São PauloLucas Cata Preta Stolzemburg - Universidade de São PauloAndre Luis Bettiati Junior - Universidade de São PauloCaroline de Almeida Gonçalves - AC Camargo HospitalAna Paula Cursino Briet de Almeida - AC Camargo HospitalAllana Maria Gomes Giordano - Beneficência Portuguesa de São PauloAndré Luís de Godoy - AC Camargo HospitalDante Altenfelder - AC Camargo HospitalJulia Nicioli - AC Camargo HospitalAlexandre Coelho Guimarães - Department of Surgical Oncology, Hospital Salvalus, São Paulo, BrazilAlejandro Serrablo Requejo - Hospital Universitario Miguel ServetAlessandro Landskron Diniz - AC Camargo HospitalAlexandre Ferreira Oliveira - AC Camargo HospitalAlice C. Wei - Memorial Sloan Kettering Cancer CenterAndré de Moricz - CASAAndre Luis Montagnini - Universidade de São PauloBrendan C. Visser - Stanford University School of MedicineCarlos H.F. Chan - University of IowaCássio Virgílio Cavalcante de Oliveira - Universidade Federal da ParaíbaCristina R. Ferrone - Cedars-Sinai Medical CenterDomenech Asbun - Department of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, FL, USAEduard Jonas - University of Cape TownEduardo J.B. Ramos - Hospital Nossa Senhora das GraçasFelix Nickel - University Medical Center Hamburg-EppendorfFilipe Kunzler de Oliveira Maia - Department of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, FL, USAFranz Robert Apodaca - Universidade de São PauloSavio George Barreto - Flinders UniversityD.Brock Hewitt - New York University School of MedicineIgor Correia de Farias - AC Camargo HospitalIsabella Frigerio - HPB Unit, Pederzoli Hospital, Peschiera del Garda, ItalyJin-Young Jang - Seoul National University HospitalMarciano Anghinoni - Surgical Oncology Unit, Centro de Oncologia do Paraná (Oncoville), Curitiba, BrazilMarcio Fernando Boff - Hospital Mãe de DeusMarcos Belotto - Universidade Nove de JulhoMariano E. Giménez - Universidad de Buenos AiresMasafumi Nakamura - Kyushu UniversityMatthew H.G. Katz - The University of Texas MD Anderson Cancer CenterMelissa E. Hogg - NorthShore Department of Surgery, Endeavor Health, Chicago, IL, USAMichael L. Kendrik - Mayo ClinicMisha D.P. Luyer - Catharina ZiekenhuisMohammad Abu Hilal - University Hospital Southampton NHS Foundation TrustNaruhiko Ikoma - The University of Texas MD Anderson Cancer CenterNicholas Joseph Zyromski - Indiana University School of MedicineNicholas Jarufe - Pontificia Universidad Católica de ChileOscar A. Guevara - Universidad Nacional de ColombiaOscar Mazza - Hospital Italiano de Buenos AiresPatricio M. Polanco - The University of Texas Southwestern Medical CenterPaulo Cezar G. Amaral - Rafael Advanced Defense Systems (Israel)Rodrigo Nascimento Pinheiro - Hospital de BaseD.Rohan Jeyarajah - Texas Christian UniversitySebastien Gaujoux - Sorbonne UniversitéShailesh V. Shrikhande - Homi Bhabha National InstituteSilvio Melo Torres - AC Camargo HospitalAjith Kumar Siriwardena - National Health ServiceTara S. Kent - Harvard Medical SchoolThilo Hackert - University Medical Center Hamburg-EppendorfTimothy M. Pawlik - The Ohio State University Wexner Medical CenterWellington Andraus - Universidade de São PauloUgo Boggi - University of PisaHoracio J. Asbun - Mayo ClinicAdnan Alseidi - University of California, San FranciscoFelipe José Fernández Coimbra - AC Camargo Hospital
- Resource Type
- Journal article
- Publication Details
- HPB (Oxford, England), Vol.28(2), pp.105-118
- DOI
- 10.1016/j.hpb.2025.11.012
- PMID
- 41419350
- NLM abbreviation
- HPB (Oxford)
- ISSN
- 1365-182X
- eISSN
- 1477-2574
- Publisher
- Elsevier Ltd; London
- Grant note
- Cole gio Brasileiro de Cirurgia Hepato PancreatoSociety of Surgical Oncology (SSO)Americas Hepato-Pancreato-Biliary Association (AHPBA)Sociedade Brasileira de Cirurgia OncologicaGrupo de Estudos do Cancer do Aparelho Digestivo (GECAD)University of California San Francisco (UCSF)
We gratefully acknowledge the support of the Cole gio Brasileiro de Cirurgia Hepato Pancreato Biliar (CBCHPB), the Society of Surgical Oncology (SSO), the Americas Hepato-Pancreato-Biliary Association (AHPBA), the Sociedade Brasileira de Cirurgia Oncologica (SBCO) and Grupo de Estudos do Cancer do Aparelho Digestivo (GECAD), and The University of California San Francisco (UCSF), during the organization of this consensus. These associations had no role in study design, data collection, analysis, or manuscript preparation, and endorsement of specific recommendations should not be inferred.
- Language
- English
- Electronic publication date
- 11/18/2025
- Date published
- 02/2026
- Academic Unit
- Surgery; Radiation Oncology
- Record Identifier
- 9985034931202771
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