ArticleInternational journal of surgery (London, England)2024
Defining and predicting textbook outcomes for perihilar cholangiocarcinoma: analysis of factors improving achievement of desired postoperative outcomes.
Article in International journal of surgery (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of preoperative biliary drainage in patients with Hilar Cholangiocarcinoma: a systematic review and meta-analysis.International journal of surgery (London, England) · 2025Pooled it
- Transitioning to the robotic era for perihilar cholangiocarcinoma: initial implementation and outcomes in a single center.Surgical endoscopy · 2026Article
- Does calculating the textbook outcome based on its negative predictors enhance the transparency of intrahepatic cholangiocarcinoma surgery assessment?Annals of hepato-biliary-pancreatic surgery · 2026Article
- Portal vein reconstruction reduces textbook outcome achievement following radical resection for hilar cholangiocarcinoma.Frontiers in oncology · 2026Article
- Preoperative prediction of textbook outcome in intrahepatic cholangiocarcinoma by interpretable machine learning: A multicenter cohort study.World journal of gastroenterology · 2025Article
- Textbook outcomes in the laparoscopic common bile duct exploration of choledocholithiasis: a new comprehensive quality evaluation criterion.Frontiers in surgery · 2025Article
- Realizing Textbook Outcomes Following Liver Resection for Hepatic Neoplasms with Development and Validation of a Predictive Nomogram.Annals of surgical oncology · 2024Article
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7 authors.
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Abstract
backgroundDefinition of textbook outcome (TO), defined as a single indicator combining the most advantageous short-term outcomes, is still lacking for perihilar cholangiocarcinoma (PHC). The primary endpoint of the present study is to analyze the rate of achievement of a disease-specific TO for PHC within a high volume tertiary referral centre. Secondary endpoints are to identify predictive factors of TO-achievement and to analyze the impact of achieving TO on long-term results.
methodsBetween 2010 and 2022, a total of 237 patients undergoing combined liver and biliary resection for PHC at tertiary referral centre were included. Disease-specific TO were defined as: no 90-day mortality, no postoperative complications, no readmission, no intraoperative transfusions and resection margins. A logistic regression model was developed to identify predictors associated with TO-achievement. Kaplan-Meier curves were designed to determine TO's impact on survival.
resultsTO was achieved in 60 (25.3%) patients. At multivariate logistic regression, preoperative biliary drainage [odds ratio (OR) 2.90 (1.13-3.40), P =0.026], high prognostic nutritional index [OR 7.11 (6.71-9.43), P =0.007[ and minimally invasive approach [OR 3.57 (2.31-3.62), P =0.013] were identified as independent predictors of TO. High ASA score [OR 0.38 (0.17-0.82), P =0.013] decreased the odds of TO. A significant improvement in both overall survival and disease-free survival was associated to TO fulfilment.
conclusionSince the achievement of TO correlates with better disease-free and overall survival, every effort should be made to ameliorate modifiable aspects prior to surery: management within referral centres with dedicated experience in biliary tract cancer and preoperative optimization protocol may positively contribute to improve postoperative outcomes, increasing the chance to obtain TO. Moreover, the implementation of advanced minimally invasive programs plays as well.
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