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

• Main Authors: 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
• Format: Article
• Language: English
• Published: Elsevier 2021-01-01
• Series: Asian Journal of Surgery
• Subjects: Pancreatic fistula; Pancreatoduodenectomy; Postoperative morbidity; Risk calculation
• Online Access: http://www.sciencedirect.com/science/article/pii/S1015958420301196
• ISSN: 1015-9584

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.