A novel postoperative inflammatory score predicts postoperative pancreatic fistula after pancreatic resection
Yuki Fujiwara1, Takeyuki Misawa, Hiroaki Shiba
1The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan. sheetan@jikei.ac.jp.
Insights
This study identified key clinical factors to predict pancreatic fistula (PF) risk after pancreatic surgery. A novel Postoperative Inflammatory Score (PIS) effectively indicates patients at high risk for PF.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Clinical Risk Stratification
Background:
- Pancreatic fistula (PF) is a significant complication following pancreatic resection.
- Identifying high-risk patients preoperatively is crucial for optimizing surgical outcomes.
Purpose of the Study:
- To characterize patients at high risk for pancreatic fistula (PF) after pancreatic resection.
- To develop a predictive tool using postoperative clinical variables.
Main Methods:
- Retrospective analysis of 297 patients undergoing pancreatic resection (2001-2011).
- Evaluation of perioperative factors and postoperative PF incidence.
- Development and validation of a Postoperative Inflammatory Score (PIS) based on serum albumin and C-reactive protein (CRP) levels on postoperative day 1.
Main Results:
- Male gender, serum albumin, and CRP on postoperative day 1 were risk factors in the early period.
- Postoperative hospital stay and the novel PIS were independent risk factors for PF in the late period.
- PIS demonstrated significant predictive value for PF in patients from the late study period.
Conclusions:
- A novel Postoperative Inflammatory Score (PIS) was developed to identify patients at risk for PF.
- This score, utilizing readily available postoperative markers, can aid in risk stratification after elective pancreatic resection.
Aim:
The aim of this study was to characterize a high-risk group of patients for pancreatic fistula (PF) after pancreatic resection using postoperative clinical variables of patients.
Patients And Methods:
The retrospective study included 297 patients who underwent pancreatic resection between January 2001 and December 2011. We examined the relationship between perioperative findings and the incidence of postoperative PF (POPF) among patients who underwent pancreatic resection between 2001 and 2009 (early period). Next, patients were stratified into three groups using serum albumin and CRP on postoperative day 1 (score 0: albumin ≥2.7 g/dl and CRP ≤10 mg/dl; score 1: albumin <2.7 g/dl or CRP >10 mg/dl; score 2: albumin <2.7 g/dl and CRP >10 mg/dl) as postoperative inflammatory score (PIS). We examined perioperative findings including PIS and POPF among patients who underwent pancreatic resection between 2010 and 2011 (late period).
Results:
In univariate and multivariate analyses, male gender (p=0.032), serum albumin on postoperative day 1 (p=0.024) and serum CRP on postoperative day 1 were identified as independent risk factors for POPF in early-period patients. In univariate and multivariate analyses, postoperative hospital stay (p=0.009) and PIS (score 1: p=0.005, score 2: p=0.017) were identifical as independent risk factors for POPF in late-period patients.
Conclusion:
We found a novel PIS to indicate risk for PF after elective pancreatic resection.
