Prediction of postoperative pancreatic fistula using a nomogram based on the updated definition

Cheng-Xiang Guo; Yi-Nan Shen; Qi Zhang; Xiao-Zhen Zhang; Jun-Li Wang; Shun-Liang Gao; Jian-Ying Lou; Ri-Sheng Que; Tao Ma; Ting-Bo Liang; Xue-Li Bai

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저자정보: Cheng-Xiang Guo (Zhejiang University School of Medicine) Yi-Nan Shen (Zhejiang University School of Medicine) Qi Zhang (Zhejiang University School of Medicine) Xiao-Zhen Zhang (Zhejiang University School of Medicine) Jun-Li Wang (Zhejiang University School of Medicine) Shun-Liang Gao (Zhejiang University School of Medicine) Jian-Ying Lou (Zhejiang University School of Medicine) Ri-Sheng Que (Zhejiang University School of Medicine) Tao Ma (Zhejiang University School of Medicine) Ting-Bo Liang (Zhejiang University School of Medicine) Xue-Li Bai (Zhejiang University School of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.98 No.2

발행연도: 2020.2

수록면: 72 - 81 (10page)

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Purpose: The International Study Group on Pancreatic Fistula’s definition of postoperative pancreatic fistula (POPF) has recently been updated. This study aimed to identify risk factors for POPF in patients having pancreaticoduodenectomy (PD) and to generate a nomogram to predict POPF.
Methods: Data on 298 patients who underwent PD from March 2012 to October 2017 was retrospectively reviewed and POPF statuses were redefined. A nomogram was constructed using data from 220 patients and validated using the remaining 78 patients. Independent risk factors for POPF were identified using univariate and multivariate analyses. A predictive nomogram was established based on the independent risk factors and was compared with existing models.
Results: Texture of the pancreas, size of the main pancreatic duct, portal vein invasion, and definitive pathology were the identified risk factors. The nomogram had a C-index of 0.793 and was internally validated. The nomogram performed better (C-index of 0.816) than the other most cited models (C-indexes of 0.728 and 0.735) in the validation cohort. In addition, the nomogram can assign patients into low- (less than 10%), intermediate- (10% to 30%), and high-risk (equal or higher than 30%) groups to facilitate personalized management.
Conclusion: The nomogram accurately predicted POPF in patients having PD.

#Clinical prediction #Nomograms #Pancreatic fistula #Risk factors #Surgery

참고문헌 (30)

참고문헌 신청

Vin Y / 2008 / Management and outcomes of postpancreatectomy fistula, leak, and abscess : results of 908patients resected at a single institution between 2000 and 2005 / J Am Coll Surg 207:490~498

llen PJ / 2014 / Pasireotide for postoperative pancreatic fistula / N Engl J Med 370:2014~2022

Ramacciato G / 2011 / Risk factors of pancreatic fistula after pancreaticoduodenectomy : a collective review / Am Surg 77:257~269

Bassi C / 2005 / Postoperative pancreatic fistula : an international study group(ISGPF)definition / Surgery 138:8~13

Bassi C / 2017 / The 2016 update of the International Study Group(ISGPS)definition and grading of postoperative pancreatic fistula : 11 years after / Surgery 161:584~591

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