A novel nomogram to predict length of stay in patients undergoing pylorus-preserving pancreaticoduodenectomy: A retrospective study.

Prolonged length of stay (LOS) following pylorus-preserving pancreaticoduodenectomy (PPPD) is associated with increased healthcare costs and patient morbidity. Accurate preoperative prediction of LOS remains a clinical challenge. This study aimed to develop and validate a novel nomogram for predicting LOS in patients undergoing PPPD. A retrospective cohort of 809 patients who underwent PPPD was analyzed. The dataset was randomly divided into training (n = 243) and validation (n = 566) sets. Univariate and multivariate analyses were performed to identify independent predictors of LOS. A nomogram was constructed based on significant variables, and its performance was evaluated using receiver operating characteristic curves, calibration plots, and decision curve analysis. Albumin, and platelet count were identified as independent predictors of LOS. The nomogram demonstrated strong discriminative ability, with an area under the curve of 0.84 (95% confidence interval: 0.75-0.93) in the training set and 0.68 (95% confidence interval: 0.43-0.93) in the validation set. Calibration plots showed excellent agreement between predicted and observed LOS, and decision curve analysis confirmed the clinical utility of the model. This study presents a validated nomogram for predicting LOS in PPPD patients, offering a practical tool for preoperative risk stratification and resource optimization.