"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
;
Chunhong ZHAO
;
Yukun CAO
;
Guangsheng YU
;
Jun LIU
Author Information
1. 250021 济南,山东大学附属山东省立医院器官移植肝胆外二科,胰腺病诊疗中心
- Publication Type:Journal Article
- 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"text-book outcome"(TO)after laparoscopic pancreaticoduodenectomy(LPD)for pancreatic ductal adenocar-cinoma(PDAC).Methods The clinical and follow-up data of patients diagnosed with PDAC and treated with LPD from January 2019 to Dec-ember 2022 were retrospectively anal-yzed.The prognosis was compared bet-ween TO and non-TO groups,and uni-variate and multivariate logistic regre-ssion 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 dia-meter>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.
