Predictors of textbook outcome deviation in robotic liver resection: a single-center retrospective study.
Textbook outcome achieved in about 4 in 5 robotic liver resections.
Predictors of textbook outcome deviation in robotic liver resection: a single-center retrospective study.
Textbook outcomes (textbook outcomes) are composite indicators of surgical quality, but their role in robotic liver resection (robotic liver resection) remains unclear.
This study aimed to define the textbook outcomes in robotic liver resection and identify the preoperative predictors of textbook outcomes deviation.
We retrospectively analyzed 94 patients who underwent robotic liver resection between September 2022 and January 2025.
The major causes of deviation included excessive blood loss, abscesses, pneumonia, and conversion.
Advanced/expert IWATE criteria and mALBI grade ≥ IIa were independent predictors in one model (OR 6.1 and 4.8), whereas advanced/expert IWATE criteria and ALPlat ≤ 593 were predictors in another (OR 5.5 and 7.1).
The composite score showed stepwise deviation rates of 4%, 9%, 36%, and 83%.
Textbook outcomes in robotic liver resection is influenced by the liver function and the complexity of the procedure.
Preoperative indices, such as the IWATE criteria, mALBI, and ALPlat, enable risk stratification and may support safer surgical planning.