Zhang JZ, Guo XY, Zhang ZW, Zhu DS, Zhang Z, Zheng H, Guo T, Yu YH, Huang XR. Textbook oncologic outcomes following pancreatoduodenectomy in patients with pancreatic adenocarcinoma: A high-volume center study. World J Gastroenterol 2026; 32(20): 119062 [DOI: 10.3748/wjg.v32.i20.119062]
Corresponding Author of This Article
Xiao-Rui Huang, MD, Doctor, Division of Hepato-Pancreato-Biliary Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430000, Hubei Province, China. xiaoruihuang826@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jing-Zhao Zhang, Xin-Yi Guo, Zhi-Wei Zhang, Deng-Sheng Zhu, Zhen Zhang, Huan Zheng, Tong Guo, Ya-Hong Yu, Xiao-Rui Huang, Division of Hepato-Pancreato-Biliary Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
Co-corresponding authors: Ya-Hong Yu and Xiao-Rui Huang.
Author contributions: Zhang JZ was responsible for data curation, conceptualization, methodology, and drafting of the original manuscript; Guo XY performed the formal data analysis; Zhang ZW and Zhu DS contributed to case collection; Zhang Z and Zheng H were responsible for patient follow-up and preliminary data organization; Guo T critically revised the manuscript and provided clinical expertise; Huang XR and Yu YH contributed equally to supervision, funding acquisition, and manuscript review and editing.
AI contribution statement: AI-assisted tools may have been used only for language polishing, grammar correction, and improvement of English readability. No AI tool was used for data analysis, statistical processing, generation of scientific content, creation of references, or development of the study conclusions.
Institutional review board statement: The study was approved by the Medical Ethics Committee of the Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (approval No. TJ-IRB202512058).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. The acquisition and use of these clinical data were approved by the Institutional Review Board.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Xiao-Rui Huang, MD, Doctor, Division of Hepato-Pancreato-Biliary Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430000, Hubei Province, China. xiaoruihuang826@163.com
Received: January 20, 2026 Revised: January 31, 2026 Accepted: February 26, 2026 Published online: May 28, 2026 Processing time: 122 Days and 22 Hours
Core Tip
Core Tip: As an emerging composite endpoint, textbook oncologic outcome (TOO) reflects both the quality and effectiveness of oncologic surgery, although its role in pancreaticoduodenectomy (PD) has not been fully elucidated. In this propensity score matching-based analysis, no significant difference in TOO achievement was observed between laparoscopic PD and open PD. Nevertheless, achieving TOO was consistently associated with improved long-term survival regardless of surgical approach. Moreover, the factors influencing TOO attainment differed between surgical strategies, underscoring the impact of postoperative complications, recovery patterns, and hepatic function. These findings support TOO as a meaningful quality indicator and advocate for individualized perioperative strategies to optimize PD outcomes.
