Related Experiment Video
Updated: Jun 14, 2025
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
Predicting pancreatic fistulas after pancreatoduodenectomy: development and internal validation of a new preoperative
Guilherme Naccache Namur1, Fernanda Lopez Mazzucato2, Ricardo Jureidini1
1Instituto do Câncer, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
Introduction:
Pancreatic Fistula (PF) is a major complication following Pancreatoduodenectomy (PD), making its prediction crucial for individualized treatment. The aim of this study is to develop a preoperative nomogram to predict PF after PD.
Material And Methods:
From January 2009 to January 2018, patients who underwent PD were reviewed. Variables with p < 0.1 from univariate analysis were selected for a multivariate analysis. Variables with p < 0.05 were then included in the nomogram, which was internally validated in a different group of patients.
Results:
262 patients underwent PD during the period of the study. The risk factors for PF identified in the derivation group were male gender (OR = 2.89), higher BMI (OR = 1.14) and pancreatic duct diameter ≤ 3 mm (OR = 3.52). Preoperative weight loss exceeding 10 % within six months was protective against PF (OR = 0.16). A preoperative nomogram incorporating these four variables was developed and demonstrated good performance in the validation set, with an area under the ROC curve of 0.798.
Conclusions:
male gender, a main pancreatic duct ≤ 3 mm and higher BMI are risk factors for PF, while weight loss is protective. The developed nomogram accurately predicts PF occurrence using these variables.
