Analysis of risk factors affecting"textbook outcome"after pancreatoduodenectomy for periampullary cancer
Objective To explore the risk factors for textbook outcome(TO)in patients with periampullary cancer after radical pancreaticoduodenectomy.Methods From December 2017 to December 2021,the relevant clinicopathological data were retrospectively reviewed for 134 patients with periampullary cancer undergoing radical pancreaticoduodenectomy.The correlations of 22 clinicopathological factors were examined.Firstly the correlation between clinical factors and TO was screened out by univariate analysis and then independent risk factors related TO were screened out by Logistic regression analysis.Results Among them,43(32.0%)reached TO and 91(67.9%)non-TO.Univariate analysis revealed that gender,intraoperative hemorrhage>525 mL,open pancreaticoduodenectomy,preoperative biliary drainage,preoperative asymptomatic leukocytosis,preoperative total bilirubin＞22 μmol/L,preoperative high CA19-9,degree of differentiation and positive lymph node were the related factors affecting postoperative TO(χ2=2.377,9.806,5.905,10.626,6.228,8.536,6.188,5.416,11.317,P<0.05);Multivariate Logistic regression analysis indicated that intraoperative hemorrhage＞525 mL,preoperative biliary drainage,open pancreaticoduodenectomy and positive lymph node were independent risk factors for TO(odds ratio= 0.341,0.311,0.946,0.228,95%confidence intervals of 0.130～0.895,0.125～0.777,1.072～8.094,0.066-0.795,P<0.05).Conclusion It can effectively predict the prognosis of patients with periampullary cancer according to whether TO is achieved after duopancreaticotomy.Intraoperative hemorrhage>525 mL,preoperative biliary drainage,open pancreaticoduodenectomy and positive lymph node are an independent risk factor for TO.
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