Defining and predicting textbook outcomes in laparoscopic distal pancreatectomy

doi:10.3748/wjg.v32.i1.115098

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Jan 7, 2026; 32(1): 115098
Published online Jan 7, 2026. doi: 10.3748/wjg.v32.i1.115098

Table 1 Baseline characteristics of 405 patients undergoing laparoscopic distal pancreatectomy, n (%)

Variables	Total (n = 405)	TO (n = 286)	TO failure (n = 119)	P value
Age (years), median IQR	51.0 (39.0-60.0)	50.0 (37.0-58.0)	53.0 (42.0-61.0)	0.025^a
Sex				0.004^a
Female	245 (60.5)	186 (65)	59 (49.6)
Male	160 (39.5)	100 (35)	60 (50.4)
BMI, median IQR	22.5 (20.3-24.7)	22.3 (20.0-24.3)	23.2 (20.7-25.1)	0.045^a
Smoker or ex-smoker	31 (7.7)	20 (7)	11 (9.2)	0.438
Diabetes	25 (6.2)	20 (7)	5 (4.2)	0.288
Cardiovascular disease	57 (14.1)	33 (11.5)	24 (20.2)	0.023^a
Previous abdominal surgery	34 (8.4)	25 (8.7)	9 (7.6)	0.697
Asymptomatic	170 (42)	123 (43)	47 (39.5)	0.514
Weight loss	56 (13.8)	34 (11.9)	22 (18.5)	0.080
ASA score				0.425
I	64 (15.8)	49 (17.1)	15 (12.6)
II	279 (68.9)	196 (68.5)	83 (69.7)
III	62 (15.3)	41 (14.3)	21 (17.6)
Lesion size (cm), median IQR	3.5 (2.2-5.2)	3.4 (2.1-5.0)	3.7 (2.5-5.4)	0.063
Lesion location				0.514
Body	189 (46.7)	136 (47.6)	53 (44.5)
Neck	45 (11.1)	34 (11.9)	11 (9.2)
Tail	171 (42.2)	116 (40.6)	55 (46.2)
Pancreatic duct dilation	73 (18)	55 (19.2)	18 (15.1)	0.328
Lesion consistency				< 0.001^a
Cystic	142 (35.1)	117 (40.9)	25 (21)
Cystic-solid	101 (24.9)	65 (22.7)	36 (30.3)
Solid	162 (40)	104 (36.4)	58 (48.7)
Pancreatitis	30 (7.4)	19 (6.6)	11 (9.2)	0.363
Pancreatic portal hypertension	27 (6.7)	13 (4.5)	14 (11.8)	0.008^a
Splenic vessel involvement	56 (13.8)	33 (11.5)	23 (19.3)	0.039^a
Preoperative EUS-FNA	21 (5.2)	10 (3.5)	11 (9.2)	0.017^a
Pancreatic texture				0.746
Hard	58 (14.3)	42 (14.7)	16 (13.4)
Soft	347 (85.7)	244 (85.3)	103 (86.6)
Local invasion	18 (4.4)	8 (2.8)	10 (8.4)	0.013^a
Anesthesia time (minute), median IQR	212.0 (180.0-255.0)	206.0 (174.0-245.0)	221.0 (191.0-285.5)	< 0.001^a
Operation time (minute), median IQR	180.0 (150.0-225.0)	178.0 (142.0-210.0)	189.0 (160.0-245.5)	0.005^a
Intraoperative blood loss (mL), median IQR	100.0 (50.0-100.0)	100.0 (50.0-100.0)	100.0 (50.0-175.0)	0.055
Intraoperative blood transfusion	16 (4)	10 (3.5)	6 (5)	0.467
Spleen preservation	179 (44.2)	139 (48.6)	40 (33.6)	0.006
Additional organ resection	4 (1)	2 (0.7)	2 (1.7)	0.363
Lymph node dissection	182 (44.9)	121 (42.3)	61 (51.3)	0.099
Malignancy	86 (21.2)	54 (18.9)	32 (26.9)	0.073
Histological diagnoses				0.033^a
CP/PPC	34 (8.4)	22 (7.7)	12 (10.1)
Cyst	13 (3.2)	10 (3.5)	3 (2.5)
IPMN	20 (4.9)	18 (6.3)	2 (1.7)
MCN	43 (10.6)	33 (11.5)	10 (8.4)
NET/NEC	45 (11.1)	29 (10.1)	16 (13.4)
PDAC	67 (16.5)	37 (12.9)	30 (25.2)
SCN	110 (27.2)	86 (30.1)	24 (20.2)
SPN	60 (14.8)	42 (14.7)	18 (15.1)
Other	13 (3.2)	9 (3.1)	4 (3.4)
Margin				1
R0	400 (98.8)	282 (98.6)	118 (99.2)
R1	5 (1.2)	4 (1.4)	1 (0.8)
Delayed gastric emptying	23 (5.7)	12 (4.2)	11 (9.2)	0.046^a

^aP < 0.05.

TO: Textbook outcome; IQR: Interquartile range; BMI: Body mass index; ASA: American Society of Anesthesiologists; EUS-FNA: Endoscopic ultrasound-guided fine-needle aspiration; CP/PPC: Chronic pancreatitis/pancreatic pseudocyst; IPMN: Intraductal papillary mucinous neoplasm; MCN: Mucinous cystic neoplasm; NET/NEC: Neuroendocrine tumor/neuroendocrine carcinoma; PDAC: Pancreatic ductal adenocarcinoma; SCN: Serous cystic neoplasm; SPN: Solid pseudopapillary neoplasm.

Full Size Table

Citation: Huang XR, Zhu DS, Guo XY, Zhang JZ, Zhang Z, Zheng H, Guo T, Yu YH, Zhang ZW. Defining and predicting textbook outcomes in laparoscopic distal pancreatectomy. World J Gastroenterol 2026; 32(1): 115098
URL: https://www.wjgnet.com/1007-9327/full/v32/i1/115098.htm
DOI: https://dx.doi.org/10.3748/wjg.v32.i1.115098

Huang XR, Zhu DS, Guo XY, Zhang JZ, Zhang Z, Zheng H, Guo T, Yu YH, Zhang ZW. Defining and predicting textbook outcomes in laparoscopic distal pancreatectomy. World J Gastroenterol 2026; 32(1): 115098 [PMID: 41551525 DOI: 10.3748/wjg.v32.i1.115098]

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