Risk scoring system and predictor for clinically relevant pancreatic fistula after pancreaticoduodenectomy

Abstract

A 6-point scoring system accurately predicted the occurrence of CR-POPF. In addition, a drain amylase level on POD3 might be a predictor of this complication.

Systematic review and meta-analysis of postoperative pancreatic fistula rates using the updated 2016 International Study Group Pancreatic Fistula definition in patients undergoing pancreatic resection with soft and hard pancreatic texture

“…Finally, 122 studies were included. Of those 122 studies, 110 studies 3, [13][14][15][17][18][19][20][21][22][111][112][113][114][115][116][117][118][119][120][121][122][123][124][125][126][127] were included in both qualitative synthesis and meta-analysis and 12 16,[128][129][130][131][132][133][134][135][136][137][138] only in the qualitative synthesis (eTable 2).…”

“…12 Among them, organ-related pancreas texture (PT) was consistently reported as the most relevant predictor of POPF. 12,13 Soft PT was included in several scoring systems designed to predict POPF after pancreatoduodenectomy (PD), 3,14,15 but a major shortcoming relies on inconsistencies in exact definition of PT among studies. [16][17][18] There is also no consensus in classifying PT; some considered only two categories: soft vs. hard; while others used three categories, such as soft/intermediate/hard PT.…”

Intra-operative amylase in peri-pancreatic fluid independently predicts for pancreatic fistula post pancreaticoduodectomy

“…Other factors known to contribute to the development of a POPF are a soft pancreas, small (<3 mm) duct, pathology other than pancreatic adenocarcinoma and increased blood loss. [9][10][11] Callery et al established the Fistula Risk Score (FRS) based on the presence or absence of these very factors for the development of POPF. 12 We hypothesized that a leak of pancreatic enzymes following a pancreaticoduodectomy (PD) is immediate, and therefore intraoperative amylase concentration (IOAC) in the peri-pancreatic fluid will be predictive of the formation of a POPF.…”

Leakage of an Invagination Pancreaticojejunostomy May Have an Influence on Mortality

“…Patients who lacked data on gland texture and duct size also were excluded, given the significance of these two factors in POPF formation. 27,28 As a result, 890 patients were available for analysis. Data on patient demographics and comorbidities, preoperative laboratory values, intraoperative characteristics, and postoperative outcomes were collected.…”