Analysis of Influencing Factors and Establishment of Nomogram Model for Textbook Outcome Achievement in Laparoscopic Resection of Hepatocellular Carcinoma

Objective: To analyse the influencing factors for textbook outcome (TO) achievement in laparoscopic hepatectomy for hepatocellular carcinoma (HCC) and to construct and validate a nomogram model. Methods: A total of 200 patients with HCC who underwent laparoscopic hepatectomy in our hospital between January 2022 and December 2024 were retrospectively analysed and divided into a TO group (n = 116) and a non-TO group (n = 84) according to the TO in liver surgery criteria. Twenty clinical parameters were collected, and after univariate analysis to screen variables, multivariate logistic regression was performed to determine independent influencing factors and establish nomograms. Model discrimination, calibration and clinical benefit were assessed using receiver operating characteristic (ROC) curves, calibration curves and decision curves. Results: Multivariate logistic analysis showed that no malnutrition before operation (odds ratio [OR] = 0.051; 95% confidence interval [CI]: 0.014-0.179), intraoperative blood loss