A modified alternative fistula risk score (a-FRS) obtained from the computed tomography enhancement pattern of the pancreatic parenchyma predicts pancreatic fistula after pancreatoduodenectomy

Tang, Bingjun; Lin, Ziying; Ma, Yue; Zhang, Aoran; Liu, Weikang; Zhang, Jixin; Wang, Xiaoying; Tian, Xiaodong; Yang, Yinmo

doi:10.1016/j.hpb.2021.04.015

Cited by 17 publications

(13 citation statements)

References 27 publications

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“…Predicting the probability of postoperative pancreatic fistula (POPF) using classical statistical (regression) modelling has received considerable attention in the published literature [32][33][34][35] . Although these models have undergone numerous iterations and validation cycles, they continue to rely on subjective assessment of pancreatic gland texture, and intraoperative blood loss (original Fistula Risk Score), which cannot be assessed until the time of surgery.…”

Section: Classical Statistical Modelling To Predict Postoperative Pan...mentioning

confidence: 99%

“…Although these models have undergone numerous iterations and validation cycles, they continue to rely on subjective assessment of pancreatic gland texture, and intraoperative blood loss (original Fistula Risk Score), which cannot be assessed until the time of surgery. Attempts have been made to overcome these issues by using parameters determined by preoperative Computed Tomogrpahy [35][36] . Nonetheless, the reported areas under the Receiving Operator Characteristic curve (aROC) range from 0.78 in original datasets to 0.67 in subsequent cohorts aiming to validate the original studies [33,37] .…”

Section: Classical Statistical Modelling To Predict Postoperative Pan...mentioning

confidence: 99%

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Machine learning for prediction of postoperative complications after hepato-biliary and pancreatic surgery

Shapey¹,

Sultan²

2023

Art Int Surg

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Machine Learning (ML) relates to the use of computer-derived algorithms and systems to enhance knowledge in order to facilitate decision making. In surgery, ML has the potential to shape clinical decision making and the management of postoperative complications in three ways: (a) by using the predicted probability of postoperative complications or survival to determine and guide optimal treatment; (b) by identifying anomalous data and patterns representing high-risk physiological states during the perioperative period and taking measures to minimise the impact of the existing risks; (c) to facilitate post-hoc identification of physiological trends, phenotypic patient characteristics, morphological characteristics of diseases, and human factors that may help alert surgeons to relevant risk factors in future patients. The accuracy, validity and integrity of data that are input into ML predictive models are central to its future success. ML could reduce errors by drawing attention to known risks of complications through supervised learning, and gain greater insights by identifying previously under-appreciated aspects of care through unsupervised learning. The success of ML in enhancing patient care will be determined by the human potential to incorporate data science techniques into daily clinical practice.

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Section: Classical Statistical Modelling To Predict Postoperative Pan...mentioning

confidence: 99%

Section: Classical Statistical Modelling To Predict Postoperative Pan...mentioning

confidence: 99%

Machine learning for prediction of postoperative complications after hepato-biliary and pancreatic surgery

Shapey¹,

Sultan²

2023

Art Int Surg

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“…The postoperative pancreatic fistula (POPF) remains one of the most significant postoperative complications after PD, which significantly increases postoperative in-hospital stay and medical burden ( 4 ). A growing body of study proposed the predicted models to evaluate the risk of POPF after pancreatic surgery ( 5 , 6 ). The management of intraperitoneal drainage plays a crucial role in the process of postoperative recovery of patients undergoing PD.…”

Section: Introductionmentioning

confidence: 99%

Safety evaluation of early drain removal following pancreaticoduodenectomy: A single-center retrospective cohort study

et al. 2022

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ObjectivesThe effects of early drain removal (EDR) on postoperative complications after pancreaticoduodenectomy (PD) remains to be investigated. This single-center retrospective cohort study was designed to explore the safety of EDR after PD.MethodsA total of 112 patients undergoing PD with drain fluid amylase (DFA) on postoperative day (POD) 1 and 3 <= 5000 were divided into EDR and late drain removal (LDR). Propensity Score Matching (PSM) was used. We compared postoperative outcomes between two groups and explore the risk factors of total complications using univariate and multiple logistic regression analyses.ResultsNo statistical differences were found in primary outcomes, including Grade B/C postoperative pancreatic fistula (POPF) (Original cohort: 5.71% vs. 3.90%; P = 1.000; PSM cohort: 3.33% vs. 6.67%; P = 1.000), and total complications (Original cohort: 17.14% vs. 32.47%; P = 0.093; PSM cohort: 13.33% vs. 33.33%; P = 0.067). The EDR was associated with shorter in-hospital stay (Original cohort: 11 days vs. 15 days; P < 0.0001; PSM cohort: 11 days vs. 15 days; P < 0.0001).ConclusionsEDR on POD 3 is safe for patients undergoing PD with low risk of POPF.

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“…Existe boa correlação entre ambos os métodos, sem diferenças significativas observadas entre eles 83 . Alguns escores utilizaram o diâmetro do ducto de forma categórica 30,41,66 e outros como variável contínua 34,35,74,76 . Conjectura-se que ductos pancreáticos mais finos sejam fatores de risco para FP, pois estão relacionados a menor grau de fibrose do parênquima 37 , tornando a anastomose pancreatojejunal tecnicamente mais difícil.…”

Section: Risco Para Fístula Pancreática -Análise Univariadaunclassified

“…Roberts et al76 constataram que pacientes com FP apresentavam maior atenuação do parênquima pancreático na fase não contrastada da TC, mas isso não foi estatisticamente significante na análise multivariada, achados estes ratificados por Hong et al81 . Tang et al74 constataram que, além de maior atenuação do parênquima na fase não contrastada em estudo de TC, os pacientes com FP apresentam maior razão entre atenuação nas fases arterial e venosa e, então, os autores propuseram modificar os escores de Callery et al30 e Mungroop et al35 , substituindo a textura do parênquima pela razão estudada, elaborando, assim, um escore pré-operatório. Hashimoto et al78 correlacionaram o padrão da contrastação…”

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Fatores de risco associados às fístulas pancreáticas em duodenopancreatectomias: desenvolvimento e validação interna de nomograma pré-operatório

Namur¹

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Aos meus pais, Roberto e Lizette, pela dedicação, carinho, afeto e constante incentivo, sem os quais nenhuma de minhas realizações seria possível.Ao meu irmão, Alexandre, meu melhor amigo e maior exemplo de determinação e força de vontade. À minha madrinha, tia e amiga, Miriam, que sempre olhou o melhor em mim. Aos meus avós, William, Novart, Laurice e Gabriel, que pavimentaram minha estrada até aqui e vivem na memória de quem sempre os amará. Aos meus tios-avós, Jenny, Georgina e Walter, que me deram o privilégio de ter mais três avós. À minha esposa, Rafaela, por me ajudar na correção desta tese, e, principalmente, por estar a meu lado e fazer com que eu queira ser sempre uma pessoa melhor. Ao meu orientador, Prof. Dr. Ulysses Ribeiro Jr., pelo constante incentivo e direção em todas as etapas deste trabalho. Ao Prof. Dr. Ricardo Jureidini, pelos muitos anos de amizade, pelo tanto que me ensinou e pelas contribuições fundamentais para este trabalho. Ao Prof. Dr. Manoel Rocha e à Dra. Fernanda Mazzucato, pela colaboração indispensável na revisão dos exames de imagem. Ao Prof. Ivan Cecconello, mestre desde os tempos de faculdade; ao Prof. Telesforo Bacchella, chefe e amigo desde a residência; ao Prof. Sérgio Nahas, um dos grandes incentivadores de minha carreira; e ao Prof. Luiz Augusto Carneiro D'Albuquerque, pelos conselhos na elaboração deste trabalho. Ao Dr. Thiago Ribeiro, grande amigo; à Profa. Dra. Estela Figueira; e aos demais colegas do Serviço de Cirurgia de Vias Biliares e Pâncreas. À Profa. Dra. Cristina Pires Camargo, cuja ajuda foi fundamental para elaboração do nomograma. Ao Sr. Rogério Prado, pelo trabalho estatístico, que é o cerne desta pesquisa. Aos professores José Jukemura, Carlos Frederico Marques e André Roncon, pela revisão minuciosa durante o exame de qualificação. Aos meus amigos Flávio Kawamoto, Rodrigo Ambar, Allan Garms, pelos muitos anos de amizade e incentivo na elaboração desta tese. À Sra. Vilma Libério, pelo suporte desde minha matrícula até o depósito da tese. E aos demais colegas das Disciplinas de Cirurgia do Aparelho Digestivo e Coloproctologia.Esta tese está de acordo com as seguintes normas, em vigor no momento desta publicação: Referências: adaptado de International Committee of Medical Journals Editors (Vancouver).

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A modified alternative fistula risk score (a-FRS) obtained from the computed tomography enhancement pattern of the pancreatic parenchyma predicts pancreatic fistula after pancreatoduodenectomy

Cited by 17 publications

References 27 publications

Machine learning for prediction of postoperative complications after hepato-biliary and pancreatic surgery

Machine learning for prediction of postoperative complications after hepato-biliary and pancreatic surgery

Safety evaluation of early drain removal following pancreaticoduodenectomy: A single-center retrospective cohort study

Fatores de risco associados às fístulas pancreáticas em duodenopancreatectomias: desenvolvimento e validação interna de nomograma pré-operatório

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