ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2014
Evaluation of a recently described risk classification scheme for pancreatic fistulae development after pancreaticoduodenectomy without routine post-operative drainage.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Calculating the risk of a pancreatic fistula after a pancreaticoduodenectomy: a systematic review.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2015Pooled it
- Intra-abdominal drainage following pancreatic resection: A systematic review.World journal of gastroenterology · 2015Pooled it
- Validation of the Updated Alternate Fistula Risk Score for Prediction of Postoperative Pancreatic Fistula After Pancreatoduodenectomy.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- Validation of original, alternative, and updated alternative fistula risk scores after open and minimally invasive pancreatoduodenectomy in an Asian patient cohort.Surgical endoscopy · 2023Article
- Is it time to standardize patient factors for HPB surgery?HPB : the official journal of the International Hepato Pancreato Biliary Association · 2014Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
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Abstract
backgroundPost-operative pancreatic fistula (POPF) formation occurs frequently after a pancreaticoduodenectomy (PD). Recently, a 10-point Fistula Risk Score (FRS) evaluating the likelihood of clinically relevant POPF (CR-POPF) development has been described and validated. This scheme has yet to be evaluated in PD patients managed without intra-operative drain placement.
methodsAmong patients undergoing PD at an academic centre since 2003, a retrospective analysis calculating FRS and its correlation with CR-POPF development was evaluated by logistic regression. Secondary analysis examined presentation and management of CR-POPF in undrained PD patients.
resultsFRS was calculated for 265 patients; 97.7% were managed without operative drains. The overall incidence of CR-POPF was 7.9%. Logistic regression revealed a 1.6-fold increase in CR-POPF risk per 1-point increase in FRS [95% confidence interval (CI) 1.2-2.0]. The negative predictive value in patients with FRS <3 was 100%, whereas the positive predictive value of FRS >6 was 16.7%. The median time to CR-POPF diagnosis was 18 days [interquartile range (IQR) 13-23]; 70.0% required readmission and 10.0% required a laparotomy.
conclusionsAmong patients without operative drainage, CR-POPF often has delayed presentations but most are managed non-operatively. The predictive value of high-risk FRS appears limited; conversely, a low-risk FRS accurately predicts the absence of CR-POPF and seems an appropriate metric for guiding care.
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