Gastric retraction time as a metric for comparing suspension techniques in laparoscopic pancreatic resection:a retrospective cohort study

Gastric retraction time as a metric for comparing suspension techniques in laparoscopic pancreatic resection:a retrospective cohort study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Gastric retraction time as a metric for comparing suspension techniques in laparoscopic pancreatic resection:a retrospective cohort study Yini Xu, Haitao Zhou, Bin Zhang, Yingan Zhao, Jiyun Zhu, Jianfeng Lu, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8459858/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background To compare the impact of a novel versus a traditional gastric suspension technique on gastric retraction time and its associated clinical benefits, and to investigate the clinical value of gastric retraction time as a core indicator for evaluating the efficacy of gastric suspension techniques in laparoscopic pancreatic surgery. Methods Clinical data of 98 patients who underwent laparoscopic distal pancreatectomy or local pancreatic resection between January 2021 and July 2025 were retrospectively analyzed. Among them, 52 patients were treated with a proposed triangular anchoring gastric suspension technique (experimental group), while 46 patients received the conventional double-point fixation gastric suspension technique previously used at our center (control group). Using gastric retraction time as the primary evaluation metric, operative time, intraoperative blood loss, postoperative complications, and length of hospital stay were compared between the two groups. The predictive value of this metric was validated using ROC curve analysis and univariate and multivariate analyses. Results The novel suspension technique significantly shortened gastric retraction time and reduced total operative time, without increasing suspension-related complications. No significant difference was observed in the overall complication rate between the two groups. Multivariate analysis identified the suspension technique as the strongest independent predictor of gastric retraction time, while maximum tumor diameter and the type of surgical procedure also significantly influenced gastric retraction time. Conclusion Gastric retraction time can serve as a key quantitative indicator for evaluating gastric suspension techniques. The novel technique significantly enhances surgical efficiency by optimizing surgical field exposure and shortening this time, proving to be both safe and feasible. Trial registration Clinical trial number: not applicable. gastric retraction time novel gastric suspension technique laparoscopic pancreatic surgery surgical efficiency evaluation metric Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Background Pancreatic tumors, particularly those located in the body and tail, including serous cystic neoplasms, pancreatic neuroendocrine tumors, and ductal adenocarcinoma, are being diagnosed with increasing frequency due to the continuous advancement of imaging techniques.[ 1 ] Distal pancreatectomy represents the standard treatment for both benign and malignant tumors of the pancreatic body and tail.[ 2 ] For eligible non-invasive proximal pancreatic tumors, local pancreatic resection offers significant advantages in preserving pancreatic function, minimizing trauma, and accelerating recovery, establishing it as the preferred surgical procedure. [ 3 ]Owing to the minimally invasive benefits of less postoperative pain, faster early recovery, shorter hospital stay, fewer wound complications, and superior cosmetic outcomes, laparoscopic surgery for pancreatic tumors has progressively replaced open surgery as the mainstream approach .[ 4 – 9 ]However,the deep retroperitoneal location of the pancreas, surrounded by vital vessels and organs, complicates the use of laparoscopic approaches in this area.[ 10 ]Achieving sufficient surgical exposure is essential for precise operative maneuvering. Since the stomach entirely obscures the pancreas during laparoscopic resection, suspending the gastric body becomes a key procedural step.[ 11 ] Various gastric suspension methods have been proposed by surgeons.[ 12 – 18 ] Nevertheless, traditional suspension techniques often remain reliant on an assistant using instruments to retract the gastric body, presenting limitations such as suboptimal stability, short duration of effective retraction, and potential injury to surrounding tissues due to excessive traction. To overcome these limitations, we developed a triangular anchoring technique for gastric suspension, which offers improved stability and reduces tissue injury. The duration of gastric retraction serve s as a direct indicator of the effectiveness of the suspension technique. However, current quantitative research centered on this metric remains scarce.To address this gap, this study focuses on the gastric traction time as the core indicator and proposes the following research question: For patients undergoing laparoscopic pancreatic surgery, can the use of triangular anchoring gastric suspension technology significantly shorten the gastric traction time and improve surgical efficiency compared to traditional gastric suspension technology? Meanwhile, can the duration of gastric traction be used as a reliable quantitative indicator to evaluate the efficacy of gastric suspension technique in laparoscopic pancreatic surgery? This study aims to answer the above questions by comparing the clinical effects of two techniques, in order to provide a basis for optimizing the laparoscopic pancreatic surgery process. Methods 1. Study Design and Reporting Guidelines This was a single-center, retrospective cohort study conducted in accordance with the STROBE statement. The study protocol was reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Ningbo University(Approval No.:2025-212RS). The requirement for individual patient informed consent was waived due to the retrospective nature of the study. 2 Study Population: A total of 98 patients who underwent laparoscopic distal pancreatectomy or local pancreatic resection at our hospital from January 2021 to July 2025 were retrospectively enrolled. Among them, 52 patients received the novel gastric suspension technique, while the other 46 patients received the conventional gastric suspension technique.The inclusion criteria were as follows: diagnosis of pancreatic body/tail disease confirmed by clinical symptoms, imaging examinations, and laboratory tests, meeting the indications for laparoscopic surgery; absence of concomitant major organic diseases of the heart, lungs, or kidneys, and no coagulation disorders; successful performance of laparoscopic distal pancreatectomy or local pancreatic resection; all primary surgeries performed by the same senior attending surgeon and completed by the same surgical team; and utilization of a gastric suspension technique during the procedure.Exclusion criteria included: presence of severe cardiac, pulmonary, hepatic, or renal dysfunction rendering the patient unable to tolerate surgery; history of major upper abdominal surgery leading to severe intra-abdominal adhesions; diagnosis of psychiatric disorders or cognitive impairment preventing adequate cooperation with the study; and multiple lesions precluding the successful performance of the intended surgery. Observed Indicators: Preoperative Baseline Characteristics: Age, gender, Body Mass Index (BMI), and underlying diseases such as hypertension, diabetes, and preoperative pancreatitis (defined as acute pancreatitis meeting the revised Atlanta criteria upon the patient's current admission[ 19 ]). Pancreatic Tumor Characteristics: Pathological type of the tumor, including intraductal papillary mucinous neoplasm (IPMN), ductal adenocarcinoma, neuroendocrine tumor, mucinous cystic neoplasm (MCN), solid pseudopapillary tumor (SPT), serous cystic neoplasm (SCN), fibrotic cystic wall tissue, among others; and the maximum diameter of the pancreatic tumor. Surgery-Related Indicators: Surgical procedure, operative time, gastric suspension time, gastric retraction time, intraoperative blood loss, requirement for intraoperative blood transfusion, and conversion to open surgery. Postoperative Outcomes: Postoperative complications, including pancreatic fistula, delayed gastric emptying, postoperative hemorrhage, reoperation, length of hospital stay, and mortality. All postoperative complications were graded according to the Clavien-Dindo classification.[ 20 ] Core Indicator: Gastric retraction time was defined as the cumulative duration from the completion of gastric suspension until the end of the surgery during which the assistant and/or primary surgeon used instruments to continuously retract the stomach (recorded with precision to 0.01 minutes, calculated based on surgical video recordings). 3 Surgical Technique Following the successful induction of general anesthesia, the patient was placed in the supine position. The primary surgeon stood on the patient's right side, the second assistant stood between the patient's legs, and the first assistant stood on the patient's left side. A 1 cm infraumbilical incision was made, through which a Veress needle was inserted to establish a pneumoperitoneum at 15 mmHg. Subsequently, four trocars were placed in the left and right abdomen, respectively. Surgical procedures commenced following abdominal exploration. 4 Gastric Suspension Techniques 4.1 Double-Point Fixation Gastric Suspension Technique The lesser sac was opened and the hepatogastric ligament was dissected. Using an ultrasonic scalpel, a portion of the greater omentum adjacent to the greater curvature of the gastric body was mobilized. A 4 − 0 Prolene suture was used to fix the midpoint of the greater curvature of the mid-gastric body to the midpoint (in the cephalocaudal direction) of the falciform ligament (Fig. 1 -A). Subsequently, another 4 − 0 Prolene suture was used to fix the greater curvature of the gastric fundus to the anterior abdominal wall (Fig. 1 -B), thereby completing the gastric suspension. 4.2 Triangular Anchoring Gastric Suspension Technique The lesser sac was opened and the hepatogastric ligament was dissected. Using an ultrasonic scalpel, a portion of the greater omentum along the greater curvature of the gastric body was mobilized. A sterile infusion tube (used as a suspension strap) was passed behind the posterior gastric wall and through the lesser sac. A Hem-o-lock clip was used to fix the infusion tube directly to the mid-portion of the gastric body (Fig. 2 -A). Then, another Hem-o-lock clip was used to fix this infusion tube strap (already attached to the mid-gastric body) to the midpoint (cephalocaudal direction) of the falciform ligament (Fig. 2 -B). A purse-string suture needle was inserted to the right of the xiphoid process, passed behind the hepatic edge of the divided hepatogastric ligament, and exited the abdominal wall to the left of the xiphoid process. The suspension suture was tightened and tied externally, completing the gastric suspension (Fig. 2 -C, D, E). For surgeries involving tumors located in the pancreatic tail, following the completion of the standard novel gastric suspension, an additional 4 − 0 Prolene suture was used to fix the proximal greater curvature of the gastric body to the anterior abdominal wall (Fig. 3 ). For local resections involving tumors located in the uncinate process, pancreatic head, or pancreatic neck, after completing the standard novel gastric suspension, an additional infusion tube (serving as a second suspension strap) was fixed to the gastric antrum using a Hem-o-lock clip (Fig. 4 -A). Another Hem-o-lock clip was then used to fix this infusion tube (attached to the gastric antrum) to the right upper abdominal diaphragm (Fig. 4 -B). 5 Statistical Methods Statistical analysis was performed using SPSS 25.0 (International Business Machines Corporation, Armonk, New York). Normality and homogeneity of variance were assessed for continuous variables. Data conforming to a normal distribution with homogeneous variance are presented as mean ± standard deviation (x̄ ± s), and comparisons between groups were conducted using the independent samples t-test. Data not conforming to a normal distribution or with heterogeneous variance are expressed as median (range), and the Mann-Whitney U test was used for intergroup comparisons. Categorical data are presented as percentages (%). Comparisons of proportions for non-ordered categorical data between groups were performed using the Chi-square test, while the Mann-Whitney U test was employed for ordered categorical data.In order to identify key factors influencing gastric retraction time, we plot a Receiver Operating Characteristic (ROC) curve and select the time cutoff value corresponding to the maximum Youden Index (sensitivity + specificity − 1) as the threshold for gastric retraction time. The original dataset was then regrouped based on this threshold: cases with values greater than the threshold constituted the long retraction time group, and those with values less than the threshold constituted the short retraction time group. Univariate and multivariate statistical analyses were subsequently performed based on this time-based grouping. In the univariate analysis, variables with a P-value < 0.2 were included in the multivariate logistic regression analysis. A two-tailed P-value < 0.05 was considered statistically significant for all tests. Results This retrospective study included a total of 98 patients. Among them, 52 patients who underwent the newly developed gastric suspension technique constituted the experimental group, while 46 patients who received the conventional gastric suspension technique served as the control group. All patients successfully underwent the gastric suspension procedure and completed the surgery. Comparisons of baseline characteristics between the two groups, including age, gender, underlying diseases, preoperative pancreatitis, maximum tumor diameter, surgical procedure, and pathological type, revealed no statistically significant differences (P > 0.05), indicating that the groups were comparable. See Table 1 . Table 1 Comparison of General Characteristics Between Control and Experimental Groups Overall (n = 98) Control Group (n = 46) Experimental Group (n = 52) t, z, or χ² P Age (years) 62 (14–86) 62 (22–85) 62 (14–86) 0.139 0.889 c Gender 2.707 0.100 b Male 51 (52.0%) 28 (60.9%) 23 (44.2%) / / Female 47 (48.0%) 18 (39.1%) 29 (55.8%) / / BMI (kg/m²) 22.93 ± 3.01 23.46 ± 3.42 22.47 ± 2.54 -1.639 0.105 a Underlying disease, n / / Diabetes 47 (48.0%) 21 (45.7%) 26 (50.0%) 0.189 0.667 b Hypertension 48 (50.0%) 24 (52.2%) 24 (48.0%) 0.167 0.683 b Maximum tumor diameter (mm) 25 (2–100) 30 (2–100) 25 (5–70) 1.083 0.279 c Preoperative pancreatitis, n 12 (12.2%) 8 (17.4%) 4 (7.7%) 2.137 0.144 d Surgical Approach, n 1.136 0.286 b Laparoscopic Pancreaticoduodenectomy 67 (68.4%) 29 (63.0%) 38 (73.1%) / / Laparoscopic partial pancreatectomy 31 (31.6%) 17 (37.0%) 14 (26.9%) / / Pathological Diagnosis / 0.512 d Intraductal Papillary Mucinous Neoplasm 13 (13.3%) 6 (13.0%) 7 (13.5%) / / Ductal adenocarcinoma 17 (17.3%) 10 (21.7%) 7 (13.5%) / / Adenocarcinoma 4 (4.1%) 2 (4.3%) 2 (3.8%) / / Adenosquamous carcinoma 4 (4.1%) 2 (4.3%) 2 (3.8%) / / Mucinous cystic neoplasm 8 (8.2%) 2 (4.3%) 6 (11.5%) / / Serous cystic neoplasm 18 (18.4%) 6 (13.0%) 12 (23.1%) / / Accessory spleen hyperplastic nodules 1 (1.0%) 0 (0%) 1 (1.9%) / / Neuroendocrine tumors 19 (19.4%) 12 (26.1%) 7 (13.5%) / / Solid pseudopapillary tumor 12 (12.2%) 6 (13.0%) 6 (11.5%) / / Clear cell renal cell carcinoma 2 (2.0%) 0 (0%) 2 (3.8%) / / Note: a, t-test; b, χ² test; c, Mann-Whitney U test; d, Fisher's exact test. Table 2 displays the perioperative outcomes for both groups. Comparative analysis revealed that the median gastric retraction time in the experimental group was 6.57 minutes, significantly shorter than the 35.37 minutes in the control group (P < 0.001). We found that although the proposed gastric suspension procedure itself required slightly more time (median, 12.72 vs. 7.10 minutes, P < 0.05), the total operative time in the experimental group was markedly shorter than that in the control group (median, 210.00 vs. 177.50 min, P < 0.05). This statistical result indicates that the novel gastric suspension technique effectively enhances surgical fluency and overall efficiency by reducing gastric retraction time. We observe no significant difference in intraoperative blood loss between the two groups (median, 50 vs. 100 ml, P = 0.072). The trend towards lower blood loss in the novel group,however, suggests that a stable surgical field may facilitate more precise operative maneuvers. It should be specifically noted that one patient in the control group experienced an intraoperative blood loss of 1600 ml. Preoperative imaging of this patient indicated significant pancreatic atrophy and marked pancreatic duct dilation. We suspect that tissue fibrosis and vascular adhesion may be major contributors to the large intraoperative bleeding in this patient.This case was included in the statistical analysis and is the primary reason for the wide range and higher median value of blood loss in the control group. We also conducted a comparative analysis of intraoperative blood transfusion between the two groups of patients and found no significant difference between the groups(number of cases: control 4 vs. experimental 1, P = 0.183). Among the transfused patients in the control group, three cases were associated with tumor invasion of blood vessels leading to blood loss exceeding 500 ml (including the aforementioned case with 1600 ml blood loss). The remaining transfused case in the control group, along with the single transfused case in the experimental group, had pre-existing low hemoglobin levels and poor cardiopulmonary reserve; The surgical team provides intraoperative blood transfusion to optimize postoperative recovery for these patients. Table 2 Perioperative Comparison Between Control and Experimental Groups Total (n = 98) Control Group (n = 46) Experimental group (n = 52) t, z, or χ² P Operative time (min) 195 (65–510) 210 (120–510) 177.5 (65–340) 3.231 0.001 c Suspension time(min) 10.50 (3.08–22.25) 7.10 (3.08–20.83) 12.72 (9.75–22.25) -5.114 < 0.001 c Gastric Retraction Time (min) 14.00 (0.00–195.84) 35.37 (1.04–195.84) 6.57 (0.00–64.75) 4.592 <0.001 c Intraoperative blood loss (ml) 100 (10–1600) 100 (10-1600) 50 (10–600) 1.929 0.072 c Intraoperative blood transfusion, n 5 (5.1%) 4 (8.7%) 1 (1.9%) / 0.183 d Postoperative complications (Clavien-Dindo classification), n / 0.431 d Grade I 25 (25.5%) 13 (28.3%) 12 (23.1%) / / Grade II 49 (50.0%) 21 (45.7%) 28 (53.8%) / / Grade III / / IIIa 2 (2.0%) 2 (4.3%) 0 (0.0%) / / IIIb 1 (1.0%) 1 (2.2%) 0 (0.0%) / / Grade IV 0 (0.0%) 0 (0.0%) 0 (0.0%) / / IVa 0 (0.0%) 0 (0.0%) 0 (0.0%) / / IVb 0 (0.0%) 0 (0.0%) 0 (0.0%) / / Grade V 0 (0.0%) 0 (0.0%) 0 (0.0%) / / Length of Hospital Stay (Days) 16 (9–35) 18 (10–35) 14 (9–27) 3.299 0.001 c Number of deaths, n 0 0 0 / / Note: a, t-test; b, χ² test; c, Mann-Whitney U test; d, Fisher’s exact test. Postoperative complications were also compared between the two groups. According to the Clavien-Dindo classification, there was no significant difference in the overall complication rate between the groups (number of cases: control 37 vs. experimental 40; P = 0.431). Regarding severe complications, the control group had 2 cases (4.3%) of Grade IIIa and 1 case (2.2%) of Grade IIIb complications, whereas the experimental group had no Grade III or higher complications. Neither group experienced suspension-related complications such as delayed gastric emptying. There were no deaths in either the experimental or control groups. The postoperative hospital stay was significantly shorter in the newly developed suspension group compared to the traditional suspension group (median, 14 vs. 18 days, P = 0.001), as shown in Table 2 . By plotting the ROC curve, we found that the Area Under the Curve(AUC)of gastric traction time was 0.770, indicating that this indicator has good accuracy in judgment.. The corresponding time cutoff value was 32.6 min, with a sensitivity of 56.5% and a specificity of 92.3% (Fig. 5 ). We reclassified the cases based on the length of gastric traction time and performed univariate analysis on the factors affecting gastric traction time. The results showed that the maximum tumor diameter, surgical method, and suspension method had a significant impact on gastric traction time (P < 0.05), as shown in Table 3 . Variables with a P-value < 0.2 in the univariate analysis were included as independent variables in a subsequent multivariate logistic regression analysis. The results demonstrated that the suspension technique (OR = 42.041, 95% CI: 8.544-206.873) was the strongest independent predictor of gastric retraction time (P < 0.001). Furthermore, maximum tumor diameter (OR = 1.049, 95% CI: 1.008–1.090) and surgical procedure (OR = 6.097, 95% CI: 1.341–27.727) were also identified as key factors significantly influencing gastric retraction time, as detailed in Table 4 . These results further validate the rationale for using gastric retraction time as a core indicator for evaluating the effectiveness of suspension techniques. Table 3 Univariate analysis of factors affecting gastric traction duration Overall (n = 98) Short-duration group (n = 64) Long-duration group (n = 30) t, z, or χ² P Age (years) 62 (14–86) 61 (14–86) 66.5 (24–85) 1.165 0.244 c Gender 1.097 0.295 b Male 51 (52.0%) 33 (48.5%) 18 (60.0%) / / Female 47 (48.0%) 35 (51.5%) 12 (40.0%) / / BMI (kg/m²) 22.93 ± 3.01 22.26 ± 3.01 23.71 ± 3.50 -2.091 0.039 a Underlying disease, n Diabetes 47 (48.0%) 35 (51.5%) 12 (40.0%) 1.097 0.295 b Hypertension 50 (51.0%) 32 (47.1%) 18 (60.0%) 1.395 0.238 b Maximum tumor diameter (mm) 25 (2–100) 25 (5–70) 30 (2–100) 3.773 < 0.001 c Preoperative pancreatitis, n 12 (12.2%) 6 (8.8%) 6 (20.0%) / 0.179 d Surgical Approach, n 4.478 0.034 b Laparoscopic Pancreaticoduodenectomy 67 (68.4%) 42 (61.8%) 25 (83.3%) / / Laparoscopic partial pancreatectomy 31 (31.6%) 26 (38.2%) 5 (16.7%) / / Pathological Diagnosis / 0.076 d Intracanalicular papillary mucinous neoplasm 13 (13.3%) 11 (16.2%) 2 (6.7%) / / Ductal adenocarcinoma 17 (17.3%) 6 (8.8%) 11 (36.7%) / / Adenocarcinoma 4 (4.1%) 2 (2.9%) 2 (6.7%) / / Adenosquamous carcinoma 4 (4.1%) 2 (2.9%) 2 (6.7%) / / Mucinous cystic neoplasm 8 (8.2%) 6 (8.8%) 2 (6.7%) / / Serous cystic neoplasm 18 (18.4%) 13 (19.1%) 5 (16.7%) / / Accessory spleen hyperplastic nodules 1 (1.0%) 1 (1.5%) 0 (0.0%) / / Neuroendocrine tumors 19 (19.4%) 15 (22.1%) 4 (13.3%) / / Solid pseudopapillary tumor 12 (12.2%) 10 (14.7%) 2 (6.7%) / / Clear cell renal cell carcinoma 2 (2.0%) 2 (2.9%) 0 (0.0%) / / Suspension Type 27.398 < 0.001 b New Model 52 (53.1%) 48 (70.6%) 4 (13.3%) / / Traditional 46 (46.9%) 20 (29.4%) 26 (86.7%) / / Intraoperative blood loss 100 (10-1600) 50 (10–1600) 100 (10–800) 1.546 0.122 c Note: a, t-test; b, χ² test; c, Mann-Whitney U test; d, Fisher's exact test. Table 4 Multivariate analysis of factors affecting gastric traction time Variable Name B S.E. Wald df P OR 95% CI BMI 0.070 0.099 0.495 1 0.482 1.072 0.883–1.303 Maximum tumor diameter 0.047 0.020 5.678 1 0.017 1.049 1.008–1.090 Pathological Type 0.155 0.119 1.680 1 0.195 1.167 0.924–1.475 Suspension method 3.739 0.813 21.147 1 < 0.001 42.041 8.544–206.873 Surgical Approach 1.808 0.773 5.474 1 0.019 6.097 1.341–27.727 Preoperative pancreatitis -0.030 1.048 0.001 1 0.977 0.971 0.124–7.577 Intraoperative blood loss -0.002 0.002 0.845 1 0.358 0.998 0.995–1.002 Discussion Laparoscopic pancreatectomy and laparoscopic local pancreatectomy have now developed into safe and feasible surgical methods. Compared to open surgery,these minimally invasive surgery has many significant advantages such as reducing abdominal wall trauma, minimizing intraoperative bleeding, reducing postoperative complications, and shortening hospital stay.[ 4 , 21 , 22 ]With advancements in surgical techniques and instrumentation, the application of minimally invasive approaches in pancreatic resection is becoming increasingly widespread.[ 23 ] However, the limited operating space of laparoscopy and the complex anatomical structure of the pancreas pose higher requirements for clear exposure of the surgical field of view.[ 10 ] In this context, due to the complete obstruction of the pancreatic surgery area by the gastric body, effective gastric suspension is a key link in ensuring the safety and precise operation of laparoscopic pancreatic surgery. [ 11 ] Previous studies have introduced various gastric suspension methods, such as Dokmak et al.'s [ 13 ]"double gastric hanging technique" and Hirono et al.'s[ 15 ]"CRESCENT technique," to improve stability and reduce assistant dependence. These reports, however, primarily offered technical descriptions without objective metrics for evaluation. Our study addresses this gap by proposing "Gastric Retraction Time" as a quantitative core parameter, enabling a systematic comparison between our novel triangular anchoring technique and the conventional two-point fixation. The traditional method, which uses two Prolene sutures to anchor the gastric fundus and body, offers limited stability. This often results in an obscured surgical view, requiring continuous manual retraction that causes visual field fluctuation, operator fatigue, and potential tissue injury. To overcome these drawbacks, we developed a triangular anchoring technique that constructs a stable mechanical system by integrating a purse-string suture with an infusion tube-Hem-o-lock clip assembly. This design provides durable gastric suspension, which frees the assistant from retraction duties to better support the surgeon with primary surgeon in tasks such as suction and tension adjustment. This study is the first to employ "Gastric Retraction Time" as a quantitative evaluation metric.We define this indicator as the cumulative time spent by the assistant and the primary surgeon using instruments to pull the stomach after gastric suspension is completed.Our research indicates that this indicator has significant scientific and clinical value.This metric is accurately recorded through surgical video review, avoiding biases associated with subjective evaluation. Traditional assessments often rely on subjective surgical field ratings or qualitative descriptions ,making it difficult to compare different techniques fairly.For instance, while Dokmak et al. reported that double gastric hanging improved exposure, they did not quantify the assistant's operative involvement [ 13 ].Similarly, Jin et al., in their study on a suspension system, recorded only total operative time without analyzing suspension efficiency per se[ 18 ]. In contrast, "Gastric Retraction Time" directly reflects the autonomous stability provided by the suspension technique. A shorter retraction time indicates more reliable fixation and less need for assistant intervention, thereby this indicator fills the gap in previous research and provides an objective benchmark for technical comparison.In addition,our findings demonstrate a clear correlation between this metric and surgical efficiency. In this study, the median gastric retraction time in the novel triangular anchoring suspension group was only 6.57 minutes, significantly lower than the 35.37 minutes observed in the control group (P < 0.001). Correspondingly, total operative time was also markedly shorter in the experimental group(177.50 minutes vs. 210.00 minutes, P < 0.05). These results confirm that the metric effectively captures improvements in surgical fluency resulting from technical refinements, corroborating conclusions from studies such as Chen et al. that the triangular suspension technique reduces operative time[ 12 ].The reduction in retraction time directly reflects the enhanced stability of the surgical field and exhibits a significant correlation with overall efficiency, quantitatively illustrating the causal link between technical improvement and time savings.This metric also has broad applicability across laparoscopic procedures. Organ suspension is a critical step for achieving adequate exposure in various minimally invasive surgeries. The proposed evaluation method is not limited to pancreatic surgery but can be extended to other contexts. For example, during pancreatoduodenectomy, retraction of the liver,particularly the left lobe,is essential for exposure. While conventional methods rely on an assistant to hold instruments, suspension techniques such as round ligament fixation may improve efficiency by minimizing manual retraction time. Introducing a measure analogous to "Gastric Retraction Time," such as "Liver Retraction Time," could serve as an objective indicator for evaluating exposure efficiency in such procedures. Moreover, in gastrointestinal or urologic surgeries, retraction time of the peritoneum or other organs may similarly function as a quantitative measure for assessing technical advancements. Despite requiring slightly longer setup, the novel triangular anchoring technique yielded a net reduction in total operative time through markedly shorter retraction periods. (median, 177.50 vs. 210.00 minutes, P < 0.05). It is noteworthy that the recorded suspension time encompassed the initial learning phase, during which several cases exceeded 20 minutes. With growing surgical proficiency, however, the procedure was consistently completed within approximately 10 minutes.The difference in gastric suspension time between the two groups did not reach statistical significance (median, 12.72 vs. 7.10 minutes, P < 0.05). Furthermore, a decreasing trend in intraoperative blood loss was observed in the experimental group (median, 50ml vs. 100ml, P = 0.072). While not statistically significant, this pattern suggests that a stabilized surgical field may promote more precise dissection and effective hemostasis(median, 50 vs. 100ml). These findings align with Dokmak et al.’s report on the double gastric hanging technique,further highlighting the extended clinical value of the gastric retraction time metric employed in our study.[ 13 ] We conducted a univariate analysis on the influencing factors of assistant assisted gastric traction time, and the results showed that the maximum tumor diameter, surgical method, and suspension method had a significant impact on the assistant assisted gastric traction time(P < 0.05). Subsequent multivariate logistic regression analysis confirmed that the suspension technique (OR = 42.041, 95% CI: 8.544-206.873) was the strongest independent predictor of gastric retraction time (P < 0.001). Maximum tumor diameter (OR = 1.049, 95% CI: 1.008–1.090) and surgical procedure (OR = 6.097, 95% CI: 1.341–27.727) were also identified as key independent factors influencing this metric (P < 0.05). The gastric traction time of the triangular anchor suspension group was significantly shorter than that of the two-point fixed suspension group, indicating the direct improvement effect of the technical modification on surgical field stability and operative efficiency. Gastric retraction time was significantly longer for distal pancreatectomy compared to local pancreatic resection. This is likely attributable to the need for continuous exposure from the pancreatic tail to the splenic hilum throughout distal pancreatectomy, whereas local resection requires exposure of only a limited surgical field, resulting in a relatively smaller area obscured by the stomach. Regarding postoperative recovery, no significant difference was observed in the overall complication rate between the two groups (80.5% vs. 76.9%, P = 0.431). The number of Grade II complications was higher in the experimental group compared to the control group (number of cases: 24 vs. 28). We observed 2 cases (4.3%) of severe complications requiring interventional treatment (grade IIIa) and 1 case of severe complications requiring surgical treatment (grade IIIb) in the control group, while none occurred in the experimental group, but this difference was not statistically significant. The occurrence of postoperative pancreatic fistula (POPF), a major complication following pancreatic surgery, is influenced by numerous factors, including patient age, intraoperative blood loss, soft pancreatic texture, BMI, multivisceral resection, splenectomy, and operative time. The prevailing view considers soft pancreatic texture a significant risk factor for POPF.[ 24 , 25 ] However, no effective preventive measures currently exist for this specific risk factor. Our findings indicate that effective gastric suspension does not confer a preventive effect against POPF.Furthermore, in our study, the postoperative hospital stay was significantly shorter in the novel suspension group compared to the traditional suspension group (median, 14 vs. 18 days, P = 0.001). This difference is likely attributable to the occurrence of severe complications (Clavien-Dindo grade ≥ III) in 3 patients within the control group, necessitating interventional procedures or reoperations, which substantially prolonged their hospitalization. This consequently elevated the overall median stay for the control group. This result may suggest the potential clinical value of the novel gastric suspension technique in preventing severe complications and promoting postoperative recovery. Various gastric suspension methods have been proposed previously by surgeons. [ 12 – 18 ]However, many of these techniques primarily suspend the central portion of the stomach, allowing the gastric ends to remain dependent and potentially obscure the surgical field. Dokmak et al. employed a bilateral gastric suspension technique using a tape. While this provided better exposure than simple mid-gastric suspension, it involved additional procedural steps, prolonged the suspension procedure time, and required placement of an extra trocar port. [ 13 ]Our triangular anchoring gastric suspension method,howervr, selectively performs double gastric suspension for tumors located in the pancreatic uncinate process, pancreatic head, pancreatic neck, and other areas, and only uses two infusion tubes as suspension straps to fix the two ends of the stomach to the abdominal wall. This method does not require additional sleeve needle holes, thus improving the efficiency of the suspension operation We further compared and analyzed the new gastric suspension technology in this study with traditional gastric suspension technology and other gastric suspension methods published in previous studies,[ 12 , 13 , 15 , 18 ]and found that the triangular anchoring gastric suspension technology in this study has more advantages in surgical efficiency and postoperative recovery compared to traditional methods and some existing technologies.For instance, the median operative time in our experimental group (177.50 min) was significantly shorter than that in our control group and the operative times reported in other studies (See Table 5 ). However, there are baseline differences between different studies, such as the maximum diameter of tumors in the Safi Dokmak group reaching 200mm, while the experimental group in this study was only 70mm. These situations may affect the comparability of results, and we still need to pay attention to the potential challenges of technology promotion. In the future, larger sample sizes and more rigorous research designs are needed to help us further validate its clinical value and the scientific validity of the "gastric traction time" indicator, and promote the standardization process of technology..Based on the findings of this study, future optimization of organ suspension techniques could center on the evaluation metric of "Organ Instrument Retraction Time." Incorporating this parameter into surgical assessment systems would provide objective and comparable data for evaluating different suspension methods across various procedures. Combining "Retraction Time" with subjective indicators such as Surgical Field Exposure Scores could help establish a multidimensional technical evaluation framework. Further research can explore the applicability of this indicator in robotic surgery or single port laparoscopic surgery to promote the development of minimally invasive technology. Table 5 Comparison of Past and Current Studies on Gastric Suspension Technique-Related Indicators Variable Name This Study Safi Dokmak Jin Ming Hao Chen Seiko Hirono Number of cases (n) Control group 46 14 17 34 63 Experimental group 52 14 16 28 24 Age (years) Control group 62 (22–85) 60 65 60.1 ± 11 68 (28–86) Experimental group 62 (14–86) 62 57 60.8 ± 9.1 70.5 (14–85) BMI (kg/m²) Control group 23.46 ± 3.42 24 (19–32) 23.73 (19.66–25.53) 22.9 ± 3.5 22.1 (16.0–34.5) Experimental group 22.47 ± 2.54 27 (22–36) 23.18 (21.84–26.22) 23.5 ± 3.1 21.6 (17.5–27.9) Maximum tumor diameter (mm) Control group 30 (2–100) 28 (8–80) 28 (20–70) 30 (22.8, 50) NA Experimental group 25 (5–70) 67 (7–200) 30 (20–48) 40.3 ± 20.8 NA Surgical duration (min) Control group 210 (120–510) 201 (120–260) 283 ± 63 218.5 ± 33.6 303 (140–545) Experimental Group 177.5 (65–340) 181 (120–260) 237 ± 61 188.9 ± 21 234 (153–416) Blood loss (ml) Control group 100 (10–1600) 118 (10–400) 100 (100–200) 185.9 ± 59.3 60 (5–3420) Experimental group 50 (10–600) 67 (10–200) 75 (50–100) 150.7 ± 35.8 25 (5–3170) Intraoperative blood transfusion (n) Control group 4 (8.7%) 0 (0%) 0 (0%) 3 (8.8%) 2 (3.2%) Experimental group 1 (1.9%) 0 (0%) 3 (18.8%) 1 (3.6%) 1 (4.2%) Grade B/C pancreatic fistula (n) Control group 24 (52.2%) 3 (17%) 0 (0%) 8 (23.5%) NA Experimental group 28 (53.8%) 3 (17%) 3 (18.8%) 5 (17.9%) NA Reoperation (n) Control group 3 (6.5%) 1 (7%) 0 (0%) 1 (2.9%) 9 (14.3%) Experimental group 0 (0%) 0 (0%) 0 (0%) 0 (0%) 2 (8.3%) Length of hospital stay (days) Control group 18 (10–35) 20 (11–32) 17 (15–20) 20.4 ± 4.9 NA Experimental group 14 (9–27) 18 (8–30) 13 (11–17) 12.4 ± 4.0 NA Although this study has achieved certain results, we recognize that there are still certain limitations in terms of sample size and other aspects. The sample size included in this study is relatively limited (n = 98), and it is a single center retrospective design. These factors may lead to a certain degree of selection bias, affecting the broad applicability of the research conclusions. At the same time, all surgical procedures were performed by the same senior doctor and their team, which did not take into account the learning curve effects of surgeons with different levels of experience, thus limiting the comprehensive evaluation of the universality of this technology. And due to the lack of long-term follow-up data, the potential impact of this suspension technique on gastric function is still unclear. Looking ahead to the future, it is necessary to further expand the sample size through multi center randomized controlled trials to systematically verify the scientific and clinical feasibility of the "gastric traction time" indicator, and to deeply quantify the practical value of triangular anchoring gastric suspension technology in promotion and application. Conclusions The "gastric traction time" proposed in this study is a key indicator for quantitatively evaluating the effectiveness of gastric suspension technology and has important clinical significance. The new triangular anchoring gastric suspension technology, with its structural innovation, effectively shortens this time, significantly optimizing the overall process of laparoscopic pancreatic tail and local resection surgery, and improving operational efficiency and convenience. This indicator not only accurately reflects the advantages and disadvantages of gastric suspension technology itself, but also has a significant correlation with multiple factors such as maximum tumor diameter and surgical method, reflecting strong comprehensive evaluation ability. Its inherent application logic can also be extended to the evaluation of organ traction technology in other surgeries, further promoting the systematic optimization of surgical processes through the strategy of replacing instrument traction with fixed suspension. If future research can utilize multicenter randomized controlled trials and interdisciplinary collaboration to fully incorporate organ traction time into the minimally invasive surgical evaluation system, it will undoubtedly promote the standardization and normalization of organ suspension technology, thereby ensuring the safety and effectiveness of surgical operations. Declarations Ethics approval and consent to participate This was a single-center, retrospective cohort study conducted in accordance with the STROBE statement. The study protocol was reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Ningbo University (Approval No.:2025-212RS). The requirement for individual patient informed consent was waived due to the retrospective nature of the study. Consent for publication Approval for publication was granted by the Ethics Committee of The First Affiliated Hospital of Ningbo University. Competing interests The authors declare that they have no competing interests. Funding This study was supported the Zhejiang Provincial Medicine and Health Science and Technology Program (No. 2024KY1499 and No. 2025KY1322); the Ningbo Key Research and Development Program for 2025 (No. 2023Z210); and the Ningbo Key Research and Development Program for 2035 (No. 2024Z301). The funder had no role in the design, data collection, data analysis, or reporting of this study. Author Contribution Conception or design of the work: XYN,ZHT,ZSM. Data collection: XYN,ZYA,LJF,ZJH. Data analysis and interpretation: XYN, ZHT,ZJY. Drafting the article: XYN, ZB. Critical revision of the article: XYN, ZHT, ZSM. Other (study supervision, fundings, materials, etc.:XYN,ZHT,ZB,ZYA,ZJY,LJF,ZJH,ZSM . Acknowledgements Not applicable. Data Availability The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. References Ardeshna DR, Cao T, Rodgers B, Onongaya C, Jones D, Chen W, Koay EJ, Krishna SG. Recent advances in the diagnostic evaluation of pancreatic cystic lesions. World J Gastroenterol. 2022;28(6):624–34. 10.3748/wjg.v28.i6.624 . Vojtko M, Cmarkova K, Pindura M, Palkoci B, Kycina R, Nosakova L, Vojtko M, Banovcin P, Miklusica J. Distal pancreatectomy. 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1","display":"","copyAsset":false,"role":"figure","size":569394,"visible":true,"origin":"","legend":"\u003cp\u003eDouble-Point Fixation Gastric Suspension Techniqu.\u003cbr\u003e\n(A) Fixation of the mid-greater curvature of the gastric body to the falciform ligament.\u003cbr\u003e\n(B) Fixation of the greater curvature of the gastric fundus to the anterior abdominal wall.\u003c/p\u003e\n\u003cp\u003eBoth steps are performed using 4-0 Prolene sutures.\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8459858/v1/a25eadd3fd69c03224cb451e.jpeg"},{"id":100010606,"identity":"42fd52af-6560-449a-9206-b094496bf504","added_by":"auto","created_at":"2026-01-12 06:07:21","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1425965,"visible":true,"origin":"","legend":"\u003cp\u003eTriangular Anchor Gastric Suspension Technique.\u003c/p\u003e\n\u003cp\u003e(A) An infusion tube strap is positioned behind the stomach and fixed to the gastric body. (B) The strap is then anchored to the falciform ligament. (C-E) A purse-string suture is placed and tightened to complete the triangular suspension, retracting the stomach anteriorly.\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8459858/v1/e4203bd546bd5a0af4867a6c.jpeg"},{"id":100010602,"identity":"2bb25c61-0382-4a9a-b1a7-39102f033c3f","added_by":"auto","created_at":"2026-01-12 06:07:21","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":417223,"visible":true,"origin":"","legend":"\u003cp\u003eAdditional steps of the novel gastric suspension technique for tumors in the pancreatic tail region.\u003cbr\u003e\nAn additional 4-0 Prolene suture is placed to fix the proximal greater curvature to the anterior abdominal wall. This provides enhanced exposure for surgical access to the pancreatic tail region.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8459858/v1/e4c95b8f48a101a38d7a239c.png"},{"id":100010611,"identity":"79ccf127-bd21-4892-a7e8-4b7f0f902ef4","added_by":"auto","created_at":"2026-01-12 06:07:21","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":328686,"visible":true,"origin":"","legend":"\u003cp\u003eAdditional steps of the novel gastric suspension technique for tumors in the pancreatic head region.\u003cbr\u003e\n(A) A second infusion tube strap is fixed to the gastric antrum.\u003cbr\u003e\n(B) The strap is then anchored to the right upper abdominal diaphragm, optimizing exposure for proximal pancreatic lesions.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-8459858/v1/452734292b1e74ddb777d45f.png"},{"id":100010607,"identity":"607cfbd8-8273-4980-92bf-0daad6d810c7","added_by":"auto","created_at":"2026-01-12 06:07:21","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":30278,"visible":true,"origin":"","legend":"\u003cp\u003eReceiver operating characteristic (ROC) curve for gastric retraction time.\u003cbr\u003e\nThe ROC curve assesses the predictive accuracy of gastric retraction time for distinguishing suspension technique efficacy. The area under the curve (AUC) is 0.770, with an optimal cutoff value of 32.6 minutes.\u003c/p\u003e","description":"","filename":"floatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-8459858/v1/3e8b6f8379c729ec84c11e7f.png"},{"id":100803975,"identity":"44a23770-7b52-4f02-85d3-427c940cfcf3","added_by":"auto","created_at":"2026-01-21 14:33:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4162249,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8459858/v1/ae5743ef-b840-44f4-9906-f77dd45568d4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Gastric retraction time as a metric for comparing suspension techniques in laparoscopic pancreatic resection:a retrospective cohort study","fulltext":[{"header":"Background","content":"\u003cp\u003ePancreatic tumors, particularly those located in the body and tail, including serous cystic neoplasms, pancreatic neuroendocrine tumors, and ductal adenocarcinoma, are being diagnosed with increasing frequency due to the continuous advancement of imaging techniques.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] Distal pancreatectomy represents the standard treatment for both benign and malignant tumors of the pancreatic body and tail.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] For eligible non-invasive proximal pancreatic tumors, local pancreatic resection offers significant advantages in preserving pancreatic function, minimizing trauma, and accelerating recovery, establishing it as the preferred surgical procedure. [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]Owing to the minimally invasive benefits of less postoperative pain, faster early recovery, shorter hospital stay, fewer wound complications, and superior cosmetic outcomes, laparoscopic surgery for pancreatic tumors has progressively replaced open surgery as the mainstream approach .[\u003cspan additionalcitationids=\"CR5 CR6 CR7 CR8\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]However,the deep retroperitoneal location of the pancreas, surrounded by vital vessels and organs, complicates the use of laparoscopic approaches in this area.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]Achieving sufficient surgical exposure is essential for precise operative maneuvering. Since the stomach entirely obscures the pancreas during laparoscopic resection, suspending the gastric body becomes a key procedural step.[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] Various gastric suspension methods have been proposed by surgeons.[\u003cspan additionalcitationids=\"CR13 CR14 CR15 CR16 CR17\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] Nevertheless, traditional suspension techniques often remain reliant on an assistant using instruments to retract the gastric body, presenting limitations such as suboptimal stability, short duration of effective retraction, and potential injury to surrounding tissues due to excessive traction. To overcome these limitations, we developed a triangular anchoring technique for gastric suspension, which offers improved stability and reduces tissue injury. The duration of gastric retraction \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eserve\u003c/span\u003es as a direct indicator of the effectiveness of the suspension technique. However, current quantitative research centered on this metric remains scarce.To address this gap, this study focuses on the gastric traction time as the core indicator and proposes the following research question: For patients undergoing laparoscopic pancreatic surgery, can the use of triangular anchoring gastric suspension technology significantly shorten the gastric traction time and improve surgical efficiency compared to traditional gastric suspension technology? Meanwhile, can the duration of gastric traction be used as a reliable quantitative indicator to evaluate the efficacy of gastric suspension technique in laparoscopic pancreatic surgery? This study aims to answer the above questions by comparing the clinical effects of two techniques, in order to provide a basis for optimizing the laparoscopic pancreatic surgery process.\u003c/p\u003e "},{"header":"Methods","content":"\n\u003ch3\u003e1. Study Design and Reporting Guidelines\u003c/h3\u003e\n\u003cp\u003eThis was a single-center, retrospective cohort study conducted in accordance with the STROBE statement. The study protocol was reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Ningbo University(Approval No.:2025-212RS). The requirement for individual patient informed consent was waived due to the retrospective nature of the study.\u003c/p\u003e \u003cp\u003e2 Study Population: A total of 98 patients who underwent laparoscopic distal pancreatectomy or local pancreatic resection at our hospital from January 2021 to July 2025 were retrospectively enrolled. Among them, 52 patients received the novel gastric suspension technique, while the other 46 patients received the conventional gastric suspension technique.The inclusion criteria were as follows: diagnosis of pancreatic body/tail disease confirmed by clinical symptoms, imaging examinations, and laboratory tests, meeting the indications for laparoscopic surgery; absence of concomitant major organic diseases of the heart, lungs, or kidneys, and no coagulation disorders; successful performance of laparoscopic distal pancreatectomy or local pancreatic resection; all primary surgeries performed by the same senior attending surgeon and completed by the same surgical team; and utilization of a gastric suspension technique during the procedure.Exclusion criteria included: presence of severe cardiac, pulmonary, hepatic, or renal dysfunction rendering the patient unable to tolerate surgery; history of major upper abdominal surgery leading to severe intra-abdominal adhesions; diagnosis of psychiatric disorders or cognitive impairment preventing adequate cooperation with the study; and multiple lesions precluding the successful performance of the intended surgery.\u003c/p\u003e \u003cp\u003eObserved Indicators:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePreoperative Baseline Characteristics: Age, gender, Body Mass Index (BMI), and underlying diseases such as hypertension, diabetes, and preoperative pancreatitis (defined as acute pancreatitis meeting the revised Atlanta criteria upon the patient's current admission[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePancreatic Tumor Characteristics: Pathological type of the tumor, including intraductal papillary mucinous neoplasm (IPMN), ductal adenocarcinoma, neuroendocrine tumor, mucinous cystic neoplasm (MCN), solid pseudopapillary tumor (SPT), serous cystic neoplasm (SCN), fibrotic cystic wall tissue, among others; and the maximum diameter of the pancreatic tumor.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSurgery-Related Indicators: Surgical procedure, operative time, gastric suspension time, gastric retraction time, intraoperative blood loss, requirement for intraoperative blood transfusion, and conversion to open surgery.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePostoperative Outcomes: Postoperative complications, including pancreatic fistula, delayed gastric emptying, postoperative hemorrhage, reoperation, length of hospital stay, and mortality. All postoperative complications were graded according to the Clavien-Dindo classification.[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eCore Indicator: Gastric retraction time was defined as the cumulative duration from the completion of gastric suspension until the end of the surgery during which the assistant and/or primary surgeon used instruments to continuously retract the stomach (recorded with precision to 0.01 minutes, calculated based on surgical video recordings).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e\n\u003ch3\u003e3 Surgical Technique\u003c/h3\u003e\n\u003cp\u003eFollowing the successful induction of general anesthesia, the patient was placed in the supine position. The primary surgeon stood on the patient's right side, the second assistant stood between the patient's legs, and the first assistant stood on the patient's left side. A 1 cm infraumbilical incision was made, through which a Veress needle was inserted to establish a pneumoperitoneum at 15 mmHg. Subsequently, four trocars were placed in the left and right abdomen, respectively. Surgical procedures commenced following abdominal exploration.\u003c/p\u003e\n\u003ch3\u003e4 Gastric Suspension Techniques\u003c/h3\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Double-Point Fixation Gastric Suspension Technique\u003c/h2\u003e \u003cp\u003eThe lesser sac was opened and the hepatogastric ligament was dissected. Using an ultrasonic scalpel, a portion of the greater omentum adjacent to the greater curvature of the gastric body was mobilized. A 4\u0026thinsp;\u0026minus;\u0026thinsp;0 Prolene suture was used to fix the midpoint of the greater curvature of the mid-gastric body to the midpoint (in the cephalocaudal direction) of the falciform ligament (Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e1\u003c/span\u003e-A). Subsequently, another 4\u0026thinsp;\u0026minus;\u0026thinsp;0 Prolene suture was used to fix the greater curvature of the gastric fundus to the anterior abdominal wall (Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e1\u003c/span\u003e-B), thereby completing the gastric suspension.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Triangular Anchoring Gastric Suspension Technique\u003c/h2\u003e \u003cp\u003eThe lesser sac was opened and the hepatogastric ligament was dissected. Using an ultrasonic scalpel, a portion of the greater omentum along the greater curvature of the gastric body was mobilized. A sterile infusion tube (used as a suspension strap) was passed behind the posterior gastric wall and through the lesser sac. A Hem-o-lock clip was used to fix the infusion tube directly to the mid-portion of the gastric body (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e2\u003c/span\u003e-A). Then, another Hem-o-lock clip was used to fix this infusion tube strap (already attached to the mid-gastric body) to the midpoint (cephalocaudal direction) of the falciform ligament (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e2\u003c/span\u003e-B). A purse-string suture needle was inserted to the right of the xiphoid process, passed behind the hepatic edge of the divided hepatogastric ligament, and exited the abdominal wall to the left of the xiphoid process. The suspension suture was tightened and tied externally, completing the gastric suspension (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e2\u003c/span\u003e-C, D, E).\u003c/p\u003e \u003cp\u003eFor surgeries involving tumors located in the pancreatic tail, following the completion of the standard novel gastric suspension, an additional 4\u0026thinsp;\u0026minus;\u0026thinsp;0 Prolene suture was used to fix the proximal greater curvature of the gastric body to the anterior abdominal wall (Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFor local resections involving tumors located in the uncinate process, pancreatic head, or pancreatic neck, after completing the standard novel gastric suspension, an additional infusion tube (serving as a second suspension strap) was fixed to the gastric antrum using a Hem-o-lock clip (Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e4\u003c/span\u003e-A). Another Hem-o-lock clip was then used to fix this infusion tube (attached to the gastric antrum) to the right upper abdominal diaphragm (Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e4\u003c/span\u003e-B).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e5 Statistical Methods\u003c/h3\u003e\n\u003cp\u003eStatistical analysis was performed using SPSS 25.0 (International Business Machines Corporation, Armonk, New York). Normality and homogeneity of variance were assessed for continuous variables. Data conforming to a normal distribution with homogeneous variance are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (x̄ \u0026plusmn; s), and comparisons between groups were conducted using the independent samples t-test. Data not conforming to a normal distribution or with heterogeneous variance are expressed as median (range), and the Mann-Whitney U test was used for intergroup comparisons. Categorical data are presented as percentages (%). Comparisons of proportions for non-ordered categorical data between groups were performed using the Chi-square test, while the Mann-Whitney U test was employed for ordered categorical data.In order to identify key factors influencing gastric retraction time, we plot a Receiver Operating Characteristic (ROC) curve and select the time cutoff value corresponding to the maximum Youden Index (sensitivity\u0026thinsp;+\u0026thinsp;specificity \u0026minus;\u0026thinsp;1) as the threshold for gastric retraction time. The original dataset was then regrouped based on this threshold: cases with values greater than the threshold constituted the long retraction time group, and those with values less than the threshold constituted the short retraction time group. Univariate and multivariate statistical analyses were subsequently performed based on this time-based grouping. In the univariate analysis, variables with a P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.2 were included in the multivariate logistic regression analysis. A two-tailed P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant for all tests.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThis retrospective study included a total of 98 patients. Among them, 52 patients who underwent the newly developed gastric suspension technique constituted the experimental group, while 46 patients who received the conventional gastric suspension technique served as the control group. All patients successfully underwent the gastric suspension procedure and completed the surgery. Comparisons of baseline characteristics between the two groups, including age, gender, underlying diseases, preoperative pancreatitis, maximum tumor diameter, surgical procedure, and pathological type, revealed no statistically significant differences (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), indicating that the groups were comparable. See Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of General Characteristics Between Control and Experimental Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverall (n\u0026thinsp;=\u0026thinsp;98)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl Group (n\u0026thinsp;=\u0026thinsp;46)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eExperimental Group (n\u0026thinsp;=\u0026thinsp;52)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et, z, or χ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62 (14\u0026ndash;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62 (22\u0026ndash;85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62 (14\u0026ndash;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.889\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.707\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.100\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51 (52.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (60.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (44.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (48.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (39.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29 (55.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI (kg/m\u0026sup2;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.93\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.46\u0026thinsp;\u0026plusmn;\u0026thinsp;3.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.47\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.639\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.105\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnderlying disease, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (48.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (45.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.667\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (52.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (48.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.683\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum tumor diameter (mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (2\u0026ndash;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30 (2\u0026ndash;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (5\u0026ndash;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.279\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreoperative pancreatitis, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (12.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (17.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (7.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.144\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical Approach, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.286\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparoscopic Pancreaticoduodenectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67 (68.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (63.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38 (73.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparoscopic partial pancreatectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (31.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (37.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (26.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathological Diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.512\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraductal Papillary Mucinous Neoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (13.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (13.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuctal adenocarcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (17.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (21.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (13.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdenocarcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (4.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdenosquamous carcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (4.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMucinous cystic neoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (8.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (4.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (11.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerous cystic neoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (18.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (13.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (23.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccessory spleen hyperplastic nodules\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeuroendocrine tumors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (19.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (26.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (13.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSolid pseudopapillary tumor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (12.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (13.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (11.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClear cell renal cell carcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (2.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: a, t-test; b, χ\u0026sup2; test; c, Mann-Whitney U test; d, Fisher's exact test.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e displays the perioperative outcomes for both groups. Comparative analysis revealed that the median gastric retraction time in the experimental group was 6.57 minutes, significantly shorter than the 35.37 minutes in the control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). We found that although the proposed gastric suspension procedure itself required slightly more time (median, 12.72 vs. 7.10 minutes, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), the total operative time in the experimental group was markedly shorter than that in the control group (median, 210.00 vs. 177.50 min, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). This statistical result indicates that the novel gastric suspension technique effectively enhances surgical fluency and overall efficiency by reducing gastric retraction time. We observe no significant difference in intraoperative blood loss between the two groups (median, 50 vs. 100 ml, P\u0026thinsp;=\u0026thinsp;0.072). The trend towards lower blood loss in the novel group,however, suggests that a stable surgical field may facilitate more precise operative maneuvers. It should be specifically noted that one patient in the control group experienced an intraoperative blood loss of 1600 ml. Preoperative imaging of this patient indicated significant pancreatic atrophy and marked pancreatic duct dilation. We suspect that tissue fibrosis and vascular adhesion may be major contributors to the large intraoperative bleeding in this patient.This case was included in the statistical analysis and is the primary reason for the wide range and higher median value of blood loss in the control group. We also conducted a comparative analysis of intraoperative blood transfusion between the two groups of patients and found no significant difference between the groups(number of cases: control 4 vs. experimental 1, P\u0026thinsp;=\u0026thinsp;0.183). Among the transfused patients in the control group, three cases were associated with tumor invasion of blood vessels leading to blood loss exceeding 500 ml (including the aforementioned case with 1600 ml blood loss). The remaining transfused case in the control group, along with the single transfused case in the experimental group, had pre-existing low hemoglobin levels and poor cardiopulmonary reserve; The surgical team provides intraoperative blood transfusion to optimize postoperative recovery for these patients.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePerioperative Comparison Between Control and Experimental Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;98)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl Group (n\u0026thinsp;=\u0026thinsp;46)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eExperimental group (n\u0026thinsp;=\u0026thinsp;52)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et, z, or χ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOperative time (min)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e195 (65\u0026ndash;510)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e210 (120\u0026ndash;510)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e177.5 (65\u0026ndash;340)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuspension time(min)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.50 (3.08\u0026ndash;22.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.10 (3.08\u0026ndash;20.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.72 (9.75\u0026ndash;22.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-5.114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGastric Retraction Time (min)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.00 (0.00\u0026ndash;195.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.37 (1.04\u0026ndash;195.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.57 (0.00\u0026ndash;64.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.592\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraoperative blood loss (ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100 (10\u0026ndash;1600)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100 (10-1600)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50 (10\u0026ndash;600)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.929\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.072\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraoperative blood transfusion, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (5.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (8.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.183\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative complications (Clavien-Dindo classification), n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.431\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (25.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (28.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (23.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (45.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (53.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIIIa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (2.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (4.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIIIb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (2.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIVa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIVb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade V\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of Hospital Stay (Days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (9\u0026ndash;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (10\u0026ndash;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (9\u0026ndash;27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of deaths, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: a, t-test; b, χ\u0026sup2; test; c, Mann-Whitney U test; d, Fisher\u0026rsquo;s exact test.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ePostoperative complications were also compared between the two groups. According to the Clavien-Dindo classification, there was no significant difference in the overall complication rate between the groups (number of cases: control 37 vs. experimental 40; P\u0026thinsp;=\u0026thinsp;0.431). Regarding severe complications, the control group had 2 cases (4.3%) of Grade IIIa and 1 case (2.2%) of Grade IIIb complications, whereas the experimental group had no Grade III or higher complications. Neither group experienced suspension-related complications such as delayed gastric emptying. There were no deaths in either the experimental or control groups. The postoperative hospital stay was significantly shorter in the newly developed suspension group compared to the traditional suspension group (median, 14 vs. 18 days, P\u0026thinsp;=\u0026thinsp;0.001), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eBy plotting the ROC curve, we found that the Area Under the Curve(AUC)of gastric traction time was 0.770, indicating that this indicator has good accuracy in judgment.. The corresponding time cutoff value was 32.6 min, with a sensitivity of 56.5% and a specificity of 92.3% (Fig.\u0026nbsp;\u003cspan refid=\"Fig10\" class=\"InternalRef\"\u003e5\u003c/span\u003e). We reclassified the cases based on the length of gastric traction time and performed univariate analysis on the factors affecting gastric traction time. The results showed that the maximum tumor diameter, surgical method, and suspension method had a significant impact on gastric traction time (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Variables with a P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.2 in the univariate analysis were included as independent variables in a subsequent multivariate logistic regression analysis. The results demonstrated that the suspension technique (OR\u0026thinsp;=\u0026thinsp;42.041, 95% CI: 8.544-206.873) was the strongest independent predictor of gastric retraction time (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Furthermore, maximum tumor diameter (OR\u0026thinsp;=\u0026thinsp;1.049, 95% CI: 1.008\u0026ndash;1.090) and surgical procedure (OR\u0026thinsp;=\u0026thinsp;6.097, 95% CI: 1.341\u0026ndash;27.727) were also identified as key factors significantly influencing gastric retraction time, as detailed in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. These results further validate the rationale for using gastric retraction time as a core indicator for evaluating the effectiveness of suspension techniques.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate analysis of factors affecting gastric traction duration\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverall (n\u0026thinsp;=\u0026thinsp;98)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eShort-duration group (n\u0026thinsp;=\u0026thinsp;64)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLong-duration group (n\u0026thinsp;=\u0026thinsp;30)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et, z, or χ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62 (14\u0026ndash;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (14\u0026ndash;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.5 (24\u0026ndash;85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.244\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.295\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51 (52.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (48.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (60.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (48.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (51.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (40.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI (kg/m\u0026sup2;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.93\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.26\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.091\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.039\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnderlying disease, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (48.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (51.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (40.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.295\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50 (51.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (47.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (60.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.395\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.238\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum tumor diameter (mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (2\u0026ndash;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (5\u0026ndash;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (2\u0026ndash;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.773\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreoperative pancreatitis, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (12.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (8.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (20.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.179\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical Approach, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.478\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.034\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparoscopic Pancreaticoduodenectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67 (68.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (61.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparoscopic partial pancreatectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (31.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (38.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathological Diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.076\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntracanalicular papillary mucinous neoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (16.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuctal adenocarcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (17.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (8.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (36.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdenocarcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (2.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdenosquamous carcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (2.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMucinous cystic neoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (8.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (8.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerous cystic neoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (18.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (19.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccessory spleen hyperplastic nodules\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeuroendocrine tumors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (19.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (22.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSolid pseudopapillary tumor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (12.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (14.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClear cell renal cell carcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (2.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (2.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuspension Type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.398\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNew Model\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52 (53.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48 (70.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTraditional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46 (46.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (29.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26 (86.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraoperative blood loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100 (10-1600)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (10\u0026ndash;1600)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100 (10\u0026ndash;800)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.546\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.122\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: a, t-test; b, χ\u0026sup2; test; c, Mann-Whitney U test; d, Fisher's exact test.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate analysis of factors affecting gastric traction time\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable Name\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eS.E.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWald\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.099\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.495\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.482\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.883\u0026ndash;1.303\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum tumor diameter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.678\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.008\u0026ndash;1.090\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathological Type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.680\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.924\u0026ndash;1.475\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuspension method\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.739\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.813\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e42.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.544\u0026ndash;206.873\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical Approach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.808\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.773\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.474\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.341\u0026ndash;27.727\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreoperative pancreatitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.030\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.048\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.971\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.124\u0026ndash;7.577\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraoperative blood loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.845\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.998\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.995\u0026ndash;1.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eLaparoscopic pancreatectomy and laparoscopic local pancreatectomy have now developed into safe and feasible surgical methods. Compared to open surgery,these minimally invasive surgery has many significant advantages such as reducing abdominal wall trauma, minimizing intraoperative bleeding, reducing postoperative complications, and shortening hospital stay.[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]With advancements in surgical techniques and instrumentation, the application of minimally invasive approaches in pancreatic resection is becoming increasingly widespread.[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] However, the limited operating space of laparoscopy and the complex anatomical structure of the pancreas pose higher requirements for clear exposure of the surgical field of view.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] In this context, due to the complete obstruction of the pancreatic surgery area by the gastric body, effective gastric suspension is a key link in ensuring the safety and precise operation of laparoscopic pancreatic surgery. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/p\u003e \u003cp\u003ePrevious studies have introduced various gastric suspension methods, such as Dokmak et al.'s [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\"double gastric hanging technique\" and Hirono et al.'s[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\"CRESCENT technique,\" to improve stability and reduce assistant dependence. These reports, however, primarily offered technical descriptions without objective metrics for evaluation. Our study addresses this gap by proposing \"Gastric Retraction Time\" as a quantitative core parameter, enabling a systematic comparison between our novel triangular anchoring technique and the conventional two-point fixation. The traditional method, which uses two Prolene sutures to anchor the gastric fundus and body, offers limited stability. This often results in an obscured surgical view, requiring continuous manual retraction that causes visual field fluctuation, operator fatigue, and potential tissue injury. To overcome these drawbacks, we developed a triangular anchoring technique that constructs a stable mechanical system by integrating a purse-string suture with an infusion tube-Hem-o-lock clip assembly. This design provides durable gastric suspension, which frees the assistant from retraction duties to better support the surgeon with primary surgeon in tasks such as suction and tension adjustment.\u003c/p\u003e \u003cp\u003eThis study is the first to employ \"Gastric Retraction Time\" as a quantitative evaluation metric.We define this indicator as the cumulative time spent by the assistant and the primary surgeon using instruments to pull the stomach after gastric suspension is completed.Our research indicates that this indicator has significant scientific and clinical value.This metric is accurately recorded through surgical video review, avoiding biases associated with subjective evaluation. Traditional assessments often rely on subjective surgical field ratings or qualitative descriptions ,making it difficult to compare different techniques fairly.For instance, while Dokmak et al. reported that double gastric hanging improved exposure, they did not quantify the assistant's operative involvement [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].Similarly, Jin et al., in their study on a suspension system, recorded only total operative time without analyzing suspension efficiency per se[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In contrast, \"Gastric Retraction Time\" directly reflects the autonomous stability provided by the suspension technique. A shorter retraction time indicates more reliable fixation and less need for assistant intervention, thereby this indicator fills the gap in previous research and provides an objective benchmark for technical comparison.In addition,our findings demonstrate a clear correlation between this metric and surgical efficiency. In this study, the median gastric retraction time in the novel triangular anchoring suspension group was only 6.57 minutes, significantly lower than the 35.37 minutes observed in the control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Correspondingly, total operative time was also markedly shorter in the experimental group(177.50 minutes vs. 210.00 minutes, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). These results confirm that the metric effectively captures improvements in surgical fluency resulting from technical refinements, corroborating conclusions from studies such as Chen et al. that the triangular suspension technique reduces operative time[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].The reduction in retraction time directly reflects the enhanced stability of the surgical field and exhibits a significant correlation with overall efficiency, quantitatively illustrating the causal link between technical improvement and time savings.This metric also has broad applicability across laparoscopic procedures. Organ suspension is a critical step for achieving adequate exposure in various minimally invasive surgeries. The proposed evaluation method is not limited to pancreatic surgery but can be extended to other contexts. For example, during pancreatoduodenectomy, retraction of the liver,particularly the left lobe,is essential for exposure. While conventional methods rely on an assistant to hold instruments, suspension techniques such as round ligament fixation may improve efficiency by minimizing manual retraction time. Introducing a measure analogous to \"Gastric Retraction Time,\" such as \"Liver Retraction Time,\" could serve as an objective indicator for evaluating exposure efficiency in such procedures. Moreover, in gastrointestinal or urologic surgeries, retraction time of the peritoneum or other organs may similarly function as a quantitative measure for assessing technical advancements.\u003c/p\u003e \u003cp\u003eDespite requiring slightly longer setup, the novel triangular anchoring technique yielded a net reduction in total operative time through markedly shorter retraction periods. (median, 177.50 vs. 210.00 minutes, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). It is noteworthy that the recorded suspension time encompassed the initial learning phase, during which several cases exceeded 20 minutes. With growing surgical proficiency, however, the procedure was consistently completed within approximately 10 minutes.The difference in gastric suspension time between the two groups did not reach statistical significance (median, 12.72 vs. 7.10 minutes, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Furthermore, a decreasing trend in intraoperative blood loss was observed in the experimental group (median, 50ml vs. 100ml, P\u0026thinsp;=\u0026thinsp;0.072). While not statistically significant, this pattern suggests that a stabilized surgical field may promote more precise dissection and effective hemostasis(median, 50 vs. 100ml). These findings align with Dokmak et al.\u0026rsquo;s report on the double gastric hanging technique,further highlighting the extended clinical value of the gastric retraction time metric employed in our study.[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eWe conducted a univariate analysis on the influencing factors of assistant assisted gastric traction time, and the results showed that the maximum tumor diameter, surgical method, and suspension method had a significant impact on the assistant assisted gastric traction time(P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Subsequent multivariate logistic regression analysis confirmed that the suspension technique (OR\u0026thinsp;=\u0026thinsp;42.041, 95% CI: 8.544-206.873) was the strongest independent predictor of gastric retraction time (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Maximum tumor diameter (OR\u0026thinsp;=\u0026thinsp;1.049, 95% CI: 1.008\u0026ndash;1.090) and surgical procedure (OR\u0026thinsp;=\u0026thinsp;6.097, 95% CI: 1.341\u0026ndash;27.727) were also identified as key independent factors influencing this metric (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The gastric traction time of the triangular anchor suspension group was significantly shorter than that of the two-point fixed suspension group, indicating the direct improvement effect of the technical modification on surgical field stability and operative efficiency. Gastric retraction time was significantly longer for distal pancreatectomy compared to local pancreatic resection. This is likely attributable to the need for continuous exposure from the pancreatic tail to the splenic hilum throughout distal pancreatectomy, whereas local resection requires exposure of only a limited surgical field, resulting in a relatively smaller area obscured by the stomach.\u003c/p\u003e \u003cp\u003eRegarding postoperative recovery, no significant difference was observed in the overall complication rate between the two groups (80.5% vs. 76.9%, P\u0026thinsp;=\u0026thinsp;0.431). The number of Grade II complications was higher in the experimental group compared to the control group (number of cases: 24 vs. 28). We observed 2 cases (4.3%) of severe complications requiring interventional treatment (grade IIIa) and 1 case of severe complications requiring surgical treatment (grade IIIb) in the control group, while none occurred in the experimental group, but this difference was not statistically significant. The occurrence of postoperative pancreatic fistula (POPF), a major complication following pancreatic surgery, is influenced by numerous factors, including patient age, intraoperative blood loss, soft pancreatic texture, BMI, multivisceral resection, splenectomy, and operative time. The prevailing view considers soft pancreatic texture a significant risk factor for POPF.[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] However, no effective preventive measures currently exist for this specific risk factor. Our findings indicate that effective gastric suspension does not confer a preventive effect against POPF.Furthermore, in our study, the postoperative hospital stay was significantly shorter in the novel suspension group compared to the traditional suspension group (median, 14 vs. 18 days, P\u0026thinsp;=\u0026thinsp;0.001). This difference is likely attributable to the occurrence of severe complications (Clavien-Dindo grade\u0026thinsp;\u0026ge;\u0026thinsp;III) in 3 patients within the control group, necessitating interventional procedures or reoperations, which substantially prolonged their hospitalization. This consequently elevated the overall median stay for the control group. This result may suggest the potential clinical value of the novel gastric suspension technique in preventing severe complications and promoting postoperative recovery.\u003c/p\u003e \u003cp\u003eVarious gastric suspension methods have been proposed previously by surgeons. [\u003cspan additionalcitationids=\"CR13 CR14 CR15 CR16 CR17\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]However, many of these techniques primarily suspend the central portion of the stomach, allowing the gastric ends to remain dependent and potentially obscure the surgical field. Dokmak et al. employed a bilateral gastric suspension technique using a tape. While this provided better exposure than simple mid-gastric suspension, it involved additional procedural steps, prolonged the suspension procedure time, and required placement of an extra trocar port. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]Our triangular anchoring gastric suspension method,howervr, selectively performs double gastric suspension for tumors located in the pancreatic uncinate process, pancreatic head, pancreatic neck, and other areas, and only uses two infusion tubes as suspension straps to fix the two ends of the stomach to the abdominal wall. This method does not require additional sleeve needle holes, thus improving the efficiency of the suspension operation\u003c/p\u003e \u003cp\u003eWe further compared and analyzed the new gastric suspension technology in this study with traditional gastric suspension technology and other gastric suspension methods published in previous studies,[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]and found that the triangular anchoring gastric suspension technology in this study has more advantages in surgical efficiency and postoperative recovery compared to traditional methods and some existing technologies.For instance, the median operative time in our experimental group (177.50 min) was significantly shorter than that in our control group and the operative times reported in other studies (See Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). However, there are baseline differences between different studies, such as the maximum diameter of tumors in the Safi Dokmak group reaching 200mm, while the experimental group in this study was only 70mm. These situations may affect the comparability of results, and we still need to pay attention to the potential challenges of technology promotion. In the future, larger sample sizes and more rigorous research designs are needed to help us further validate its clinical value and the scientific validity of the \"gastric traction time\" indicator, and promote the standardization process of technology..Based on the findings of this study, future optimization of organ suspension techniques could center on the evaluation metric of \"Organ Instrument Retraction Time.\" Incorporating this parameter into surgical assessment systems would provide objective and comparable data for evaluating different suspension methods across various procedures. Combining \"Retraction Time\" with subjective indicators such as Surgical Field Exposure Scores could help establish a multidimensional technical evaluation framework. Further research can explore the applicability of this indicator in robotic surgery or single port laparoscopic surgery to promote the development of minimally invasive technology.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Past and Current Studies on Gastric Suspension Technique-Related Indicators\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable Name\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThis Study\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSafi Dokmak\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJin Ming\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHao Chen\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSeiko Hirono\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of cases (n)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62 (22\u0026ndash;85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60.1\u0026thinsp;\u0026plusmn;\u0026thinsp;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68 (28\u0026ndash;86)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62 (14\u0026ndash;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60.8\u0026thinsp;\u0026plusmn;\u0026thinsp;9.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e70.5 (14\u0026ndash;85)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI (kg/m\u0026sup2;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.46\u0026thinsp;\u0026plusmn;\u0026thinsp;3.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (19\u0026ndash;32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.73 (19.66\u0026ndash;25.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22.1 (16.0\u0026ndash;34.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.47\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (22\u0026ndash;36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.18 (21.84\u0026ndash;26.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.6 (17.5\u0026ndash;27.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum tumor diameter (mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (2\u0026ndash;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (8\u0026ndash;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (20\u0026ndash;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30 (22.8, 50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (5\u0026ndash;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67 (7\u0026ndash;200)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (20\u0026ndash;48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40.3\u0026thinsp;\u0026plusmn;\u0026thinsp;20.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical duration (min)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e210 (120\u0026ndash;510)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e201 (120\u0026ndash;260)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e283\u0026thinsp;\u0026plusmn;\u0026thinsp;63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e218.5\u0026thinsp;\u0026plusmn;\u0026thinsp;33.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e303 (140\u0026ndash;545)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e177.5 (65\u0026ndash;340)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e181 (120\u0026ndash;260)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e237\u0026thinsp;\u0026plusmn;\u0026thinsp;61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e188.9\u0026thinsp;\u0026plusmn;\u0026thinsp;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e234 (153\u0026ndash;416)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlood loss (ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100 (10\u0026ndash;1600)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118 (10\u0026ndash;400)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100 (100\u0026ndash;200)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e185.9\u0026thinsp;\u0026plusmn;\u0026thinsp;59.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60 (5\u0026ndash;3420)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50 (10\u0026ndash;600)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67 (10\u0026ndash;200)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75 (50\u0026ndash;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e150.7\u0026thinsp;\u0026plusmn;\u0026thinsp;35.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25 (5\u0026ndash;3170)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraoperative blood transfusion (n)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (8.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (8.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (3.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (18.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (3.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (4.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade B/C pancreatic fistula (n)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (52.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (23.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (53.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (18.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (17.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReoperation (n)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (6.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (2.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of hospital stay (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (10\u0026ndash;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (11\u0026ndash;32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (15\u0026ndash;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (9\u0026ndash;27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (8\u0026ndash;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (11\u0026ndash;17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAlthough this study has achieved certain results, we recognize that there are still certain limitations in terms of sample size and other aspects. The sample size included in this study is relatively limited (n\u0026thinsp;=\u0026thinsp;98), and it is a single center retrospective design. These factors may lead to a certain degree of selection bias, affecting the broad applicability of the research conclusions. At the same time, all surgical procedures were performed by the same senior doctor and their team, which did not take into account the learning curve effects of surgeons with different levels of experience, thus limiting the comprehensive evaluation of the universality of this technology. And due to the lack of long-term follow-up data, the potential impact of this suspension technique on gastric function is still unclear. Looking ahead to the future, it is necessary to further expand the sample size through multi center randomized controlled trials to systematically verify the scientific and clinical feasibility of the \"gastric traction time\" indicator, and to deeply quantify the practical value of triangular anchoring gastric suspension technology in promotion and application.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe \"gastric traction time\" proposed in this study is a key indicator for quantitatively evaluating the effectiveness of gastric suspension technology and has important clinical significance. The new triangular anchoring gastric suspension technology, with its structural innovation, effectively shortens this time, significantly optimizing the overall process of laparoscopic pancreatic tail and local resection surgery, and improving operational efficiency and convenience. This indicator not only accurately reflects the advantages and disadvantages of gastric suspension technology itself, but also has a significant correlation with multiple factors such as maximum tumor diameter and surgical method, reflecting strong comprehensive evaluation ability. Its inherent application logic can also be extended to the evaluation of organ traction technology in other surgeries, further promoting the systematic optimization of surgical processes through the strategy of replacing instrument traction with fixed suspension. If future research can utilize multicenter randomized controlled trials and interdisciplinary collaboration to fully incorporate organ traction time into the minimally invasive surgical evaluation system, it will undoubtedly promote the standardization and normalization of organ suspension technology, thereby ensuring the safety and effectiveness of surgical operations.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003eThis was a single-center, retrospective cohort study conducted in accordance with the STROBE statement. The study protocol was reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Ningbo University (Approval No.:2025-212RS). The requirement for individual patient informed consent was waived due to the retrospective nature of the study.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eConsent for publication\u003c/h2\u003e \u003cp\u003e Approval for publication was granted by the Ethics Committee of The First Affiliated Hospital of Ningbo University.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis study was supported the Zhejiang Provincial Medicine and Health Science and Technology Program (No. 2024KY1499 and No. 2025KY1322); the Ningbo Key Research and Development Program for 2025 (No. 2023Z210); and the Ningbo Key Research and Development Program for 2035 (No. 2024Z301). The funder had no role in the design, data collection, data analysis, or reporting of this study.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConception or design of the work: XYN,ZHT,ZSM. Data collection: XYN,ZYA,LJF,ZJH. Data analysis and interpretation: XYN, ZHT,ZJY. Drafting the article: XYN, ZB. Critical revision of the article: XYN, ZHT, ZSM. Other (study supervision, fundings, materials, etc.:XYN,ZHT,ZB,ZYA,ZJY,LJF,ZJH,ZSM .\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eArdeshna DR, Cao T, Rodgers B, Onongaya C, Jones D, Chen W, Koay EJ, Krishna SG. 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Ann Surg. 2007;245(4):573\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"gastric retraction time, novel gastric suspension technique, laparoscopic pancreatic surgery, surgical efficiency, evaluation metric","lastPublishedDoi":"10.21203/rs.3.rs-8459858/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8459858/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eTo compare the impact of a novel versus a traditional gastric suspension technique on gastric retraction time and its associated clinical benefits, and to investigate the clinical value of gastric retraction time as a core indicator for evaluating the efficacy of gastric suspension techniques in laparoscopic pancreatic surgery.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eClinical data of 98 patients who underwent laparoscopic distal pancreatectomy or local pancreatic resection between January 2021 and July 2025 were retrospectively analyzed. Among them, 52 patients were treated with a proposed triangular anchoring gastric suspension technique (experimental group), while 46 patients received the conventional double-point fixation gastric suspension technique previously used at our center (control group). Using gastric retraction time as the primary evaluation metric, operative time, intraoperative blood loss, postoperative complications, and length of hospital stay were compared between the two groups. The predictive value of this metric was validated using ROC curve analysis and univariate and multivariate analyses.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe novel suspension technique significantly shortened gastric retraction time and reduced total operative time, without increasing suspension-related complications. No significant difference was observed in the overall complication rate between the two groups. Multivariate analysis identified the suspension technique as the strongest independent predictor of gastric retraction time, while maximum tumor diameter and the type of surgical procedure also significantly influenced gastric retraction time.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eGastric retraction time can serve as a key quantitative indicator for evaluating gastric suspension techniques. The novel technique significantly enhances surgical efficiency by optimizing surgical field exposure and shortening this time, proving to be both safe and feasible.\u003c/p\u003e\u003ch2\u003eTrial registration\u003c/h2\u003e \u003cp\u003eClinical trial number: not applicable.\u003c/p\u003e","manuscriptTitle":"Gastric retraction time as a metric for comparing suspension techniques in laparoscopic pancreatic resection:a retrospective cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-12 06:07:13","doi":"10.21203/rs.3.rs-8459858/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c8682162-31af-4dda-9e51-2bdcf60f6bc2","owner":[],"postedDate":"January 12th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-16T16:53:47+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-12 06:07:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8459858","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8459858","identity":"rs-8459858","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}