Background/Aim: The Fistula Risk Score (FRS), as other risk scores, is a validated model predicting the development of a clinically relevant post-operative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD). We evaluated risk factors related with CR-POPF and correlated four predictive scores with the likelihood of developing CR-POPF in our cohort. Patients and Methods: The records of 107 patients who underwent PD from 2007 to 2015 were obtained from a prospectively maintained database and reviewed. CR-POPFs were categorized by the International Study Group of Pancreatic Fistula (ISGPF) standards. Firstly, a univariate and multivariate analysis of risk factors related to CR-PPOPF was performed, and then the data were correlated with FRS, Wellner's, Robert's and Yamamoto's scores. Results: In total, 30 patients developed a CR-POPF. On multivariate analysis, abdominal thickness (OR=1.02, p=0.010), Wirsung's duct diameter (OR=0.57, p=0.029), pancreatic consistency (OR=3.18, p=0.011) and histological diagnosis of the lesion (OR=1.65, p=0.012) represented independent predictive factors of CR-POPF. FRS (R 2 =0.596, p=0.001), Wellner's score (R 2 =0.285, p=0.005) and Roberts' score (R 2 =0.385, p=0.002) correlated with the likelihood of developing CR-POPF. Conclusion: Abdominal thickness, Wirsung's duct diameter, pancreatic consistency and histological diagnosis were independent predictive factors of CR-POPF. Predictive scores reflected the likelihood of CR-POPF, FRS being the score with the highest predictive value.
treatment only (2 patients, 3.3%). Eight of the 16 patients with biliary complications went on to surgical resection (50%) compared to 26 of the 43 (60.4%) patients who did not have biliary complications. (c 2 =0.18, p = 0.67). Conclusion: Biliary complications during neoadjuvant therapy for pancreatic head cancer are relatively common, but do not significantly affect proceeding to surgical resection.
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