Study on prediction of postoperative pancreatic fistula after pancreaticoduodenectomy and distal pancreatectomy

doi:10.16139/j.1007-9610.2018.05.013

Abstract

Abstract: Objective To investigate application of predictive scoring system for postoperative pancreatic fistula (POPF) issued by Division of Pancreatic Surgery Chinese Medical Association in 2017. Methods The data of 249 patients who received pancreaticoduodenectomy (PD) and 156 patients received distal pancreatectomy(DP) at our hospital from January 2014 to December 2016 were retrospectively studied. The risk factors associated with POPF were analyzed. Predictive scoring system was constructed using 4 factors including pancreatic texture, pathologic result of tumor, diameter of pancreatic duct and operative blood loss. Receiver operating characteristic (ROC) curve analysis was performed to evaluate sensitivity and specificity of predictive scoring system for prediction of POPF. Results A total of 31 (31/249,12.4%) patients undergoing PD had POPF. The results from univariate analysis showed that pancreatic texture, pathologic result of tumor, diameter of pancreatic duct and operative blood loss were risk factors of POPF of PD. ROC curve analysis showed area under the curve (AUC) of predictive scoring system 0.894 for PD (P<; 0.001, 95%CI：0.839-0.949) with sensitivity of 83.9% and specificity of 77.1%. There were 44 (44/156, 28.2%) patients undergoing DP with POPF. Diameter of pancreatic duct and operative blood loss were risk factor of POPF after DP from univariate analysis and AUC of predictive scoring system was 0.567 (P=0.190, 95%CI：0.467-0.668) with sensitivity of 84.1% and specificity of 27.7%. Conclusions The predictive scoring system POPF by Division of Pancreatic Surgery in 2017 could accurately predict the occurrence of POPF after PD, but not for POPF after DP, which needs further study.

Key words: Pancreaticoduodenectomy, Distal pancreatectomy, Postoperative pancreatic fistula, Predictive scoring system, Receiver operating characteristic curve

CLC Number:

R657.5

WANG Weishen, ZHAN Qian, WANG Wei, DENG Xiaxing, SHEN Baiyong, PENG Chenghong. Study on prediction of postoperative pancreatic fistula after pancreaticoduodenectomy and distal pancreatectomy[J]. Journal of Surgery Concepts & Practice, 2018, 23(05): 440-445.

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