“Textbook Outcome” and Influencing Factors in Patients with Pancreatic Ductal Adenocarcinoma Following Laparoscopic Pancreaticoduodenectomy: A Retrospective Cohort Study
10.3971/j.issn.1000-8578.2025.25.0344
- VernacularTitle:胰腺导管腺癌腹腔镜胰十二指肠切除术后“教科书式结局”及影响因素分析：一项回顾性队列研究
- Author:
Yakai YANG
1
;
Shuai XU
2
;
Chunhong ZHAO
3
;
Yukun CAO
2
;
Guangsheng YU
2
;
Jun LIU
2
Author Information
1. Department of Liver Transplantation and Hepatobiliary Surgery, Pancreatic Disease Diagnosis and Treatment Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
2. Department of Liver Transplantation and Hepatobiliary Surgery, Pancreatic Disease Diagnosis and Treatment Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China;Department of Liver Transplantation and Hepatobiliary Surgery, Pancreatic Disease Diagnosis and Treatment Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.
3. Department of Donation and Transplantation Management, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan 250031, China.
- Publication Type:SPECIALFEATURE
- Keywords:
Pancreatic ductal adenocarcinoma;
Laparoscopic pancreaticoduodenectomy;
Textbook outcome;
Risk factor;
Learning curve
- From:
Cancer Research on Prevention and Treatment
2025;52(10):827-833
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the short- and long-term prognoses and the risk factors affecting “textbook outcome” (TO) after laparoscopic pancreaticoduodenectomy (LPD) for pancreatic ductal adenocarcinoma (PDAC). Methods The clinical and follow-up data of patients diagnosed with PDAC and treated with LPD from January 2019 to December 2022 were retrospectively analyzed. The prognosis was compared between TO and non-TO groups, and univariate and multivariate logistic regression analyses were used to identify independent prognostic factors for TO. Results A total of 284 patients were enrolled in this study, including 185 cases in the TO group and 99 cases in the non-TO group. The 1-, 3- and 5-year overall survival (OS) rates of the TO and non-TO groups with PDAC were 87.3% vs. 85.9%, 52.5% vs. 38.4%, and 18.0% vs. 4.5%, respectively (P=0.020); the recurrence-free survival (RFS) rates were 74.1% vs. 65.7%, 27.1% vs. 21.0%, and 10.0% vs. 0%, respectively (P=0.042). Multivariate logistic regression analysis showed that operation time >360 min (OR=0.561, 95%CI: 0.321-0.979, P=0.042), intraoperative blood loss >400 ml (OR=0.392, 95%CI: 0.175-0.879, P=0.023), hard or tough texture of pancreas (OR=2.240, 95%CI: 1.247-4.022, P=0.007), and main pancreatic duct diameter >3 mm (OR=1.931, 95%CI: 1.126-3.312, P=0.017) were independent prognostic factors for TO. Conclusion After the learning curve, more than 60% of patients with PDAC can achieve TO after LPD. The chances of achieving TO are significantly reduced when the operation time >360 min, the intraoperative blood loss >400 ml, the texture of pancreas was soft, and the diameter of the main pancreatic duct >3 mm.
