Preoperative C-reactive protein and textbook outcome following pancreaticoduodenectomy for pancreatic head adenocarcinoma
Atilgan Tolga Akcam, Abdullah Ulku, Ahmet Gökhan Saritas, Serdar Gumus, Mevlut Harun Agca, Ishak Aydin, Yunus Kaycı, Burak Aydogan, Ugur Topal
Ugur Topal, Serdar Gumus, Department of Surgical Oncology, Cukurova University, Adana 01330, Türkiye
Burak Aydogan, Department of General Surgery, Islahiye State Hospital, Gaziantep 27800, Türkiye
Yunus Kaycı, Department of Gastroenterological Surgery, Adana City Training and Research Hospital, Adana 01370, Türkiye
Ishak Aydin, Mevlut Harun Agca, Ahmet Gökhan Saritas, Abdullah Ulku, Atilgan Tolga Akcam, Department of General Surgery, Cukurova University, Adana 01330, Türkiye
Author contributions: Topal U conceived and designed the study, supervised the research project, performed the statistical analysis, interpreted the data, drafted the manuscript, and acted as the corresponding author with overall responsibility for the integrity of the work; Aydogan B contributed to study design, performed data acquisition and database curation, and assisted in interpretation of the results; Kaycı Y contributed to study conception, performed data acquisition, participated in data analysis and interpretation, and drafted sections of the materials and methods and results; Aydin I contributed to data collection, performed clinical data verification, and critically revised the manuscript for important intellectual content; Agca MH contributed to patient follow-up data collection, postoperative outcome assessment, and manuscript revision; Gumus S contributed to study design, oncologic interpretation of the data, and critical revision of the discussion section; Saritas AG contributed to surgical data acquisition, interpretation of operative variables, and manuscript revision; Ulku A contributed to clinical interpretation, supervised data validation, and critically reviewed the manuscript; Akcam AT contributed to study supervision, methodological guidance, and critical revision of the manuscript for important intellectual content. All authors reviewed the final version of the manuscript, agreed on its submission, and take responsibility for the accuracy and integrity of the work.
AI contribution statement: During the preparation of this manuscript, the authors used an AI-based language model (ChatGPT, OpenAI, GPT-4) exclusively for English language editing, grammar correction, and minor stylistic refinement to improve the readability of the text. The AI tool was not involved in any aspect of study design, data collection, statistical analysis, interpretation of results, formulation of conclusions, generation of scientific content, or the selection and organization of references. All AI-assisted linguistic outputs were critically reviewed, verified, and, where necessary, revised by the authors, who assume full responsibility for the accuracy, originality, scientific integrity, and final content of the manuscript. The authors confirm that this disclosure is made in accordance with the guidelines of the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE).
Institutional review board statement: This retrospective study was reviewed and approved by the Clinical Research Ethics Committee of Çukurova University Faculty of Medicine (Approval No. 51; date of approval: March 13, 2026). The approval covered the retrospective review of anonymized institutional data from patients who underwent pancreaticoduodenectomy between March 2015 and January 2022. The study was conducted in accordance with the principles of the Declaration of Helsinki.
Informed consent statement: Because this study was based on the retrospective review of anonymized institutional data and involved no study-specific intervention or patient contact, the requirement for written informed consent was waived by the Clinical Research Ethics Committee of Çukurova University Faculty of Medicine. All patient data were de-identified prior to analysis, and patient confidentiality was strictly maintained throughout the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised in accordance with the STROBE Statement guidelines for the reporting of observational cohort studies.
Data sharing statement: The de-identified datasets generated and/or analyzed during the current study are not publicly available because of institutional data protection policies and patient privacy regulations, but are available from the corresponding author (Ugur Topal,
utopal@cu.edu.tr) upon reasonable request and subject to approval by the Clinical Research Ethics Committee of Çukurova University Faculty of Medicine. No additional data are available beyond those reported in the manuscript and its tables and figures.
Corresponding author: Ugur Topal, MD, Department of Surgical Oncology, Cukurova Univer
sity, Balcalı Mahallesi, Sarıçam, Adana 01330, Türkiye.
utopal@cu.edu.tr
Received: April 17, 2026
Revised: May 13, 2026
Accepted: June 16, 2026
Published online: August 27, 2026
Processing time: 122 Days and 7.2 Hours
