Factors associated with textbook outcome after robotic-assisted pancreatoduodenectomy: a single surgeon's retrospective cohort.

BACKGROUND

Textbook outcome (TO) represents as an important parameter in assessing the quality of surgical procedures. The factors that contributed to the achievement of the TO in robotic-assisted pancreaticoduodenectomy (RPD) have not been well-documented. This study aimed to analyze the TO in the consecutive series of RPD performed by one single surgeon and identify perioperative factors that are independently associated with TO.

METHODS

A cohort of 302 patients who underwent RPD by one single surgeon at First Affiliated Hospital of Sun Yat-sen University between July 2016 and August 2024 were retrospectively recruited into the study. The TO rates for all patients and patients after the learning curve were calculated. Baseline characteristics of patients were compared between TO and non-TO groups. Multivariate logistic regression analysis was performed to evaluate the variables associated with achieving TO.

RESULTS

TO was achieved in 57.0% of all patients who underwent RPD and in 63.2% after the learning curve. Multivariate logistic regression analysis revealed that post-learning curve (P=0.002), concomitant diabetes (P=0.009), dilated pancreatic duct (>3 mm, P=0.01), and American Society of Anesthesiologists (ASA) score ≤ II (P<0.001) were independently associated with achieving TO after RPD.

CONCLUSIONS

Our single surgeon's experience demonstrated that TO was achievable in more than half of the patients after RPD. Surgeon's learning curve, ASA score, concomitant diabetes, and dilated pancreatic duct (>3 mm) were independently associated with TO.