Risk Factors of Textbook Outcome in Laparoscopic Pancreatoduodenectomy: results from a prospective high-volume center study

Abstract Objective Achieving textbook outcome (TO) means smooth recovery after operation without specified composite complications. This study aimed to assess TO in laparoscopic pancreaticoduodenectomy (LPD) and find independent risk factors for achieving it. Methods We performed a retrospective data analysis from a randomized controlled trial in LPD conducted at West China Hospital (ChiCTR1900026653). Patients were classified into the TO and non-TO groups. Perioperative variables were compared between the two groups. Multivariate logistic regression was used to find the risk factors. Results Overall, 200 consecutive patients undergoing LPD were included in this study. TO was achieved in 82.5% (n = 165). Female patients (OR: 2.628, 95% CI: 1.101–6.269; P = 0.029) or patients with a hard pancreatic texture (OR: 2.551, 95% CI: 1.054–6.172; P = 0.038) were associated with an increased probability of achieving TO. Conclusions TO can be achieved in more than 80% of patients in a high-volume LPD center. The independent risk factors associated with achieving TO included male and soft pancreatic texture.