Evaluating nutrition and body composition can enhance post-surgery success in pancreaticoduodenectomy.

• 57.2% of patients achieved a textbook outcome, with no 30-day mortality.
• Key risk factors for not achieving a textbook outcome include age ≥75, malnutrition, and a high visceral fat to muscle ratio.

Focusing on these factors preoperatively may significantly improve patient outcomes and overall survival rates.

• Patients meeting textbook outcomes experienced better overall survival compared to those who did not.