Textbook Outcome as a Composite Outcome Measure in Laparoscopic Pancreaticoduodenectomy

Tongji Hospital

Status: Completed

Conditions: Pancreatic Neoplasms

Treatments: Other: No intervention

Study type: Observational

Funder types: Other

Identifiers

NCT05616403

TJDBPS13

Details and patient eligibility

About

This is a multicenter, retrospective, observational study. Textbook outcome is a composite outcome measure for surgical quality assessment. The aim of this study was to assess textbook outcome following laparoscopic pancreaticoduodenectomy in China, identify factors independently associated with achieving textbook outcome and analyze hospital variations regarding the textbook outcome after case-mix adjustment.

Full description

Laparoscopic pancreaticoduodenectomy (LPD) remains one of the most complex and technically challenging procedures in pancreatic surgery, although LPD has developed rapidly worldwide in recent years. Traditionally, quality assessment of LPD has mainly focused on individual outcome measures such as morbidity, mortality, operative time, operative blood transfusion, readmission rates and length of hospital stay. However, individual outcome parameters do not reflect the multiple facets of the whole surgical procedure and do not measure actual variations among different hospitals. In this context, several outcome experts have suggested that composite measures of surgical quality may be better than individual outcome parameters to compare hospital performance. Textbook outcome (TO) is such a composite outcome measure of multiple desirable outcome metrics, which was first proposed in 2013 by Dutch colorectal surgeons in order to give a comprehensive summary of hospital performance. TO is realized when all of the desired outcome parameters are achieved following surgery and represents the optimal ("textbook") hospitalization.

Although several studies on TO in pancreatic surgery have been reported, relevant data on LPD are lacking, especially from China. The objective of this study was to assess TO among patients undergoing LPD in China, identify factors independently associated with achieving TO and analyze hospital variations regarding the TO after case-mix adjustment.

Enrollment: 1,029 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients underwent laparoscopic pancreaticoduodenectomy.
2. Aged 18 to 75 years old.

Exclusion criteria

1. Peritoneal seeding or metastasis to distant sites.
2. Incomplete clinical data

Trial design

1,029 participants in 2 patient groups

Textbook outcome group

Description:

Achieving textbook outcome after laparoscopic pancreaticoduodenectomy

Treatment:

Other: No intervention

Non-Textbook outcome group

Description:

Not achieving textbook outcome after laparoscopic pancreaticoduodenectomy

Treatment:

Other: No intervention