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腹腔镜胰十二指肠切除术的教科书结局的风险因素:一项来自高容量中心前瞻性研究的结果。

Risk factors of textbook outcome in laparoscopic pancreatoduodenectomy: results from a prospective high-volume center study.

机构信息

Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.

The Health Management Center of West China Hospital, Sichuan University, Chengdu, China.

出版信息

BMC Surg. 2024 Aug 16;24(1):233. doi: 10.1186/s12893-024-02529-6.

Abstract

OBJECTIVE

Achieving textbook outcome (TO) implies a smooth recovery post-operation without specified composite complications. This study aimed to evaluate TO in laparoscopic pancreaticoduodenectomy (LPD) and identify independent risk factors associated with achieving TO.

METHODS

We conducted a retrospective analysis of data from a randomized controlled trial on LPD at West China Hospital (ChiCTR1900026653). Patients were categorized into the TO and non-TO groups. Perioperative variables were compared between these groups. Multivariate logistic regression was utilized to identify the risk factors.

RESULTS

A total of 200 consecutive patients undergoing LPD were included in this study. TO was achieved in 82.5% (n = 165) of the patients. Female patients (OR: 2.877, 95% CI: 1.219-6.790; P = 0.016) and those with a hard pancreatic texture (OR: 2.435, 95% CI: 1.018-5.827; P = 0.046) were associated with an increased likelihood of achieving TO.

CONCLUSIONS

TO can be achieved in more than 80% of patients in a high-volume LPD center. Independent risk factors associated with achieving TO included gender (male) and pancreatic texture (soft).

摘要

目的

达到教科书结果(TO)意味着手术后无需特定复合并发症即可顺利康复。本研究旨在评估腹腔镜胰十二指肠切除术(LPD)中的 TO,并确定与达到 TO 相关的独立危险因素。

方法

我们对华西医院 LPD 的一项随机对照试验数据进行了回顾性分析(ChiCTR1900026653)。将患者分为 TO 和非 TO 组。比较两组的围手术期变量。采用多因素逻辑回归分析识别危险因素。

结果

本研究共纳入 200 例连续接受 LPD 的患者。82.5%(n=165)的患者达到 TO。女性患者(OR:2.877,95%CI:1.219-6.790;P=0.016)和胰腺质地坚硬的患者(OR:2.435,95%CI:1.018-5.827;P=0.046)与达到 TO 的可能性增加相关。

结论

在高容量的 LPD 中心,超过 80%的患者可以达到 TO。与达到 TO 相关的独立危险因素包括性别(男性)和胰腺质地(软)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3b4/11328470/ac028c0884cc/12893_2024_2529_Figa_HTML.jpg

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