Preliminary Study on Influencing Factors of Textbook Outcome After Minimally Invasive Pancreaticoduodenectomy
10.3969/j.issn.1009-6604.2025.07.004
- VernacularTitle:微创胰十二指肠切除术后达到教科书式结局影响因素的初步探讨
- Author:
Long LI
1
;
Yuan LI
1
;
Weijun QI
1
;
Yuntao BING
1
;
Li ZHANG
1
;
Xingyan WANG
1
;
Lei LI
1
;
Zhaolai MA
1
;
Chunhui YUAN
1
;
Dianrong XIU
1
Author Information
1. 北京大学第三医院普通外科,北京 100191
- Publication Type:Journal Article
- Keywords:
Textbook outcome;
Pancreatic ductal adenocarcinoma;
Minimally invasive pancreaticoduodenectomy;
Pancreatic fistula
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(7):405-410
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate influencing factors of textbook outcome(TO)in patients with pancreatic ductal adenocarcinoma undergoing minimally invasive pancreaticoduodenectomy(MIPD).Methods A retrospective analysis was conducted on the clinical data of 101 cases of pancreatic ductal adenocarcinoma treated with MIPD in our hospital from January 2020 to December 2022.According to the inclusion and exclusion criteria,89 cases were ultimately included in this study,of which 61 cases reached TO(TO group)and 28 cases did not reach TO(non-TO group).Variables with P<0.05 in univariate analysis were included in multivariate logistic regression analysis to identify independent prognostic factors of TO.Results Univariate analysis showed that there were significant differences in pancreatic duct dilation>3 mm,preoperative neutrophil lymphocyte ratio(NLR),extended hospital stay,postoperative hospitalstay,and drain fluid amylase(DFA)>1100 U/L at1-3 d aftersurgery(P<0.05).Multivariate logistic regression analysis showed that the independent prognostic factors affecting TO were:pancreatic duct dilation>3 mm(OR=7.290,95%CI:1.485-35.786,P=0.014),postoperative hospital stay(OR=0.862,95%CI:0.751-0.989,P=0.034),and the DFA on the first postoperative day>1100 U/L(OR=0.052,95%CI:0.005-0.545,P=0.014).Conclusions The outcome of TO in patients after MIPD is not related to the surgical approach(robot assisted minimally invasive pancreaticoduodenectomy or laparoscopic pancreaticoduodenectomy).Pancreatic duct dilation>3 mm,postoperative hospital stay,and DFA on the first postoperative day>1100 U/L are independent prognostic factors of TO after MIPD in patients with pancreatic ductal adenocarcinoma.
