| Summary: | Jia-Yu Zhang,1,2 Jia Huang,2 Su-Ya Zhao,3 Xin Liu,4 Zhen-Cheng Xiong,5 Zhi-Ying Yang1,2 1Graduate School of Peking Union Medical College, Beijing, 100730, People’s Republic of China; 2Department of General Surgery, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China; 3Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China; 4Graduate School of Tianjin Medical University, Tianjin, 300041, People’s Republic of China; 5Institute of Medical Technology, Peking University Health Science Center, Beijing, 100029, People’s Republic of ChinaCorrespondence: Zhi-Ying YangDepartment of General Surgery, China-Japan Friendship Hospital, 2 Cherry Blossom East Street, Beijing, 100029, People’s Republic of ChinaEmail yangzhy@aliyun.comAim: In order to find the risk factors of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) according to the latest definition and grading system of International Study Group of Pancreatic Surgery (ISGPS) (version 2016) and propose a nomogram for predicting POPF.Methods: We conducted a retrospective analysis of 232 successive cases of PD performed at our hospital by the same operator from August 2012 to June 2020. POPF was diagnosed in accordance with the latest definition of pancreatic fistula from the ISGPS. The risk factors of POPF were analyzed by univariate and multivariate logistic regression analysis. A nomogram model to predict the risk of POPF was constructed based on significant factors.Results: There were 18 cases of POPF, accounting for 7.8% of the total. Among them, 17 cases were classified into ISGPF grade B and 1 case was classified into ISGPF grade C. In addition, 35 cases were classified into biochemical leak. Univariate and multivariate analysis showed that hypertension, non-diabetes, no history of abdominal surgery, antecolic gastrojejunostomy and soft pancreas were independent risk factors of POPF. Based on significant factors, a nomogram is plotted to predict the risk of POPF. The C-index of this nomogram to assess prediction accuracy was 0.916 (P < 0.001) indicating good prediction performance.Conclusion: Hypertension, non-diabetes, no history of abdominal surgery, antecolic gastrojejunostomy and soft pancreas were independent risk factors of POPF. Meanwhile, a nomogram for predicting POPF with good test performance and discriminatory capacity was constituted.Keywords: pancreaticoduodenectomy, pancreatic fistula, International Study Group of Pancreatic Surgery, prediction model
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