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©The Author(s) 2026.
World J Gastroenterol. Jan 7, 2026; 32(1): 115098
Published online Jan 7, 2026. doi: 10.3748/wjg.v32.i1.115098
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) | 0.025a |
| Sex | 0.004a | |||
| 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) | 0.045a |
| 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) | 0.023a |
| 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 | < 0.001a | |||
| 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) | 0.008a |
| Splenic vessel involvement | 56 (13.8) | 33 (11.5) | 23 (19.3) | 0.039a |
| Preoperative EUS-FNA | 21 (5.2) | 10 (3.5) | 11 (9.2) | 0.017a |
| 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) | 0.013a |
| Anesthesia time (minute), median IQR | 212.0 (180.0-255.0) | 206.0 (174.0-245.0) | 221.0 (191.0-285.5) | < 0.001a |
| Operation time (minute), median IQR | 180.0 (150.0-225.0) | 178.0 (142.0-210.0) | 189.0 (160.0-245.5) | 0.005a |
| 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 | 0.033a | |||
| 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) | 0.046a |
Table 2 Univariate and multivariate analyses of failure to achieve textbook outcome in laparoscopic distal pancreatectomy
| Variables | Univariable OR (95%CI) | P value | Multivariable OR (95%CI) | P value |
| Age ≥ 50 years | 1.44 (0.93-2.22) | 0.100 | ||
| Sex: Female | 0.53 (0.34-0.82) | 0.004a | 0.62 (0.39-0.99) | 0.046a |
| BMI grade | ||||
| 18.5-24 | Ref. | |||
| < 18.5 | 0.84 (0.39-1.81) | 0.658 | ||
| ≥ 24 | 1.50 (0.94-2.39) | 0.088 | ||
| Smoker or ex-smoker | 1.35 (0.63-2.92) | 0.439 | ||
| Alcohol | 1.55 (0.68-3.52) | 0.297 | ||
| Diabetes | 0.58 (0.21-1.59) | 0.293 | ||
| Previous abdominal surgery | 0.85 (0.39-1.89) | 0.697 | ||
| Asymptomatic | 0.87 (0.56-1.34) | 0.514 | ||
| Anemia | 1.24 (0.66-2.31) | 0.508 | ||
| Weight loss | 1.68 (0.94-3.02) | 0.082 | ||
| ASA score | ||||
| I and II | Ref. | |||
| III and IV | 1.28 (0.72-2.28) | 0.400 | ||
| Cardiovascular disease | 1.94 (1.09-3.45) | 0.025 | 1.62 (0.88-2.98) | 0.117 |
| Pancreatitis | 1.43 (0.66-3.11) | 0.365 | ||
| Lesion size (cm) | 1.07 (0.99-1.16) | 0.078 | ||
| Lesion location | ||||
| Tail | Ref. | |||
| Body | 0.82 (0.52-1.29) | 0.394 | ||
| Neck | 0.68 (0.32-1.45) | 0.319 | ||
| Lesion consistency | ||||
| Cystic | Ref. | |||
| Cystic-solid | 2.59 (1.43-4.69) | 0.002a | 2.51 (1.34-4.69) | 0.004a |
| Solid | 2.61 (1.52-4.47) | < 0.001a | 1.91 (1.06-3.44) | 0.032a |
| Splenic vessel involvement | 1.84 (1.03-3.29) | 0.041a | 0.86 (0.41-1.81) | 0. 689 |
| Pancreatic portal hypertension | 2.80 (1.27-6.16) | 0.010a | 2.81 (1.06-7.45) | 0.038a |
| Pancreatic duct dilation | 0.75 (0.42-1.34) | 0.329 | ||
| Preoperative EUS-FNA | 2.81 (1.16-6.81) | 0.022a | 2.66 (1.05-6.73) | 0.038a |
| Pancreatic texture | ||||
| Hard | Ref. | |||
| Soft | 1.11 (0.60-2.06) | 0.746 | ||
| Intraoperative blood transfusion | 1.47 (0.52-4.13) | 0.469 | ||
| Local invasion | 3.19 (1.23-8.29) | 0.017a | 1.97 (0.70-5.55) | 0.200 |
| Delayed gastric emptying | 2.33 (1.00-5.43) | 0.051 | ||
| Spleen preservation | 0.54 (0.34-0.84) | 0.006a | 0.83 (0.50-1.36) | 0.455 |
| Additional organ resection | 2.43 (0.34-17.44) | 0.378 | ||
| Lymph node dissection | 1.43 (0.93-2.20) | 0.100 | ||
| Malignancy | 1.58 (0.96-2.61) | 0.074 |
- 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