Asian Journal of Surgery (Jan 2021)

Comparison of three fistula risk scores after pancreatoduodenectomy: A single-institution retrospective study

  • Hironori Hayashi,
  • Koji Amaya,
  • Yuta Fujiwara,
  • Ryutaro Tokai,
  • Yuya Sugimoto,
  • Yu Hashimoto,
  • Makoto Nakura,
  • Shunsuke Kawai,
  • Takahisa Yamaguchi,
  • Atsushi Hirose,
  • Toshifumi Watanabe,
  • Tomoya Tsukada,
  • Masahide Kaji,
  • Kiichi Maeda,
  • Koichi Shimizu

Journal volume & issue
Vol. 44, no. 1
pp. 143 – 146

Abstract

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Summary: Background: Postoperative pancreatic fistula (POPF) after pancreatoduodenectomy greatly influences patients' postoperative course. Several evaluation methods have been used to assess the risk of clinically relevant POPF (CR-POPF) after pancreatoduodenectomy namely, the original, alternative, and updated alternative fistula risk scores (o-FRS, a-FRS, and ua-FRS, respectively). Methods: We enrolled 106/179 patients who underwent pancreatoduodenectomy in our institution between April 2013 and Mar 2018. CR-POPF was defined as grade B and C POPF according to the 2016 definitions of the International Study Group on Pancreatic Surgery. Results: Pancreatic gland texture was the only significant risk factor for CR-POPF (p = 0.007). The CR-POPF incidence increased significantly according to the risk groups defined by both o-FRS (p = 0.004) and a-FRS (p = 0.004). The area under the curve for o-FRS, a-FRS, and ua-FRS was 0.693, 0.693, and 0.671, respectively. Conclusion: o-FRS, a-FRS, and ua-FRS were almost equally useful for risk evaluation for CR-POPF after pancreatoduodenectomy. Further studies, especially for preoperative objective evaluation of pancreatic gland texture, are needed for more useful and accurate risk evaluation.

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