Risk Factors for Achieving TO After LDPPHR-t

Study Overview
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Brief Summary
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This is a single, retrospective, observational study to investigate the risk factors for achieving textbook outcome after laparoscopic duodenum-preserving total pancreatic head resection.

Detailed Description
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Increasing numbers of benign or low-grade malignant neoplasms at the head of pancreas are being diagnosed due to computed tomography (CT), magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS). Laparoscopic duodenum-preserving total pancreatic head resection (LDPPHR-t) has been accepted as a valid alternative treatment for benign and low-grade malignant neoplasms at the head of the pancreas. The evaluation of quality of LDPPHR-t is important for surgeons to improve surgical quality. Currently, the evaluation of surgical quality mainly depends on some single outcome indicators, such as morbidity, mortality, readmission rate, or hospital stay. These single outcome indicators are difficult to accurately reflect the overall surgical quality and the composite outcome measures may be better than single outcome indicators. Textbook outcome (TO) is such a composite concept and is realized when all the requirements after operation are achieved according to the all or none principle. TO reflects the ideal surgical outcome and is a multidimensional measure for surgical quality assurance. However, the risk factors for achieving TO after LDPPHR-t is unknown and no relevant articles have been reported so far. The objective of study was to identify the risk factors for achieving TO after LDPPHR-t.

Official Title
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Risk Factors for Achieving Textbook Outcome After Laparoscopic Duodenum-preserving Total Pancreatic Head Resection: a Retrospective, Observational Study

Conditions
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Pancreatic Neoplasm of Uncertain Behavior Head

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients underwent laparoscopic duodenum-preserving total pancreatic head resection. Aged 18 to 75 years old. Exclusion Criteria: Peritoneal seeding or metastasis to distant sites. Incomplete clinical data.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Textbook outcome group<br>Achieving textbook outcome after laparoscopic duodenum-preserving total pancreatic head resection | Other: No intervention<br>* This is an observational study without any intervention<br>|
| Non-Textbook outcome group<br>Not achieving textbook outcome after laparoscopic duodenum-preserving total pancreatic head resection | Other: No intervention<br>* This is an observational study without any intervention<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative complications | The postoperative complications were graded into mild complications and severe complications according to the Clavien-Dindo classification of surgical complications, including postpancreatectomy hemorrhage, postoperative pancreatic fistula , and bile leakage. | up to 90 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Operation time | Operation time defined as the time from skin incision or trocar placement to complete skin closure | Intraoperative | 
| Intraoperative blood loss | Intraoperative blood loss recorded by the anesthetist using a vacuum system | Intraoperative | 
| Readmission | Readmission defined as any readmission within 30 days after discharge | up to 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Textbook outcome, Risk factors, Endoscopic nasobiliary drainage, Total pancreatic head resection, Duodenum-preserving, Laparoscopic