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- Title
A combined score for predicting clinically relevant postoperative pancreatic fistula based on inflammatory parameters and drainage fluid culture results on postoperative day 3.
- Authors
Suto, Hironobu; Matsukawa, Hiroyuki; Ando, Yasuhisa; Oshima, Minoru; Fuke, Takuro; Norikane, Takashi; Sanomura, Takayuki; Kamada, Hideki; Kobara, Hideki; Masaki, Tsutomu; Kumamoto, Kensuke; Okano, Keiichi
- Abstract
Background: Clinically relevant postoperative pancreatic fistula (CR‐POPF) after pancreatic resection can lead to severe postoperative complications. POPF is defined based on postoperative day (POD) 3 drainage fluid amylase level. POPF correlates with inflammatory parameters as well as drainage fluid bacterial infection. However, a standardized model based on these factors for predicting CR‐POPF remains elusive. We aimed to identify inflammatory parameter‐ and drainage fluid culture‐related risk factors for CR‐POPF on POD 3 after pancreatoduodenectomy (PD) and distal pancreatectomy (DP). Methods: Data from 351 patients who underwent PD or DP between 2013 and 2022 at a single institution were retrospectively analyzed. Risk factors for CR‐POPF were investigated using multivariate analyses, and a prediction model combining the risk factors for CR‐POPF was developed. Results: Of the 351 patients, 254 and 97 underwent PD and DP, respectively. Multivariate analyses revealed that drainage fluid amylase level ≥722 IU/L, culture positivity, as well as neutrophil count ≥5473/mm3 on POD 3 were independent risk factors for CR‐POPF in PD group. Similarly, drainage fluid, amylase level ≥500 IU/L, and culture positivity on POD 3 as well as pancreatic thickness ≥11.1 mm were independent risk factors in the DP group. The model for predicting CR‐POPF achieved the maximum overall accuracy rate when the number of risk factors was ≥2 in both the PD and DP groups. Conclusions: Inflammatory parameters on POD 3 significantly influence the risk of CR‐POPF onset after pancreatectomy. The combined models based on these values can accurately predict the risk of CR‐POPF after pancreatectomy.
- Subjects
PANCREATIC fistula; DRAINAGE; PANCREATIC surgery; SURGICAL complications; MULTIVARIATE analysis; BACTERIAL diseases; PANCREATECTOMY
- Publication
World Journal of Surgery, 2024, Vol 48, Issue 5, p1231
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1002/wjs.12131