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Validation of a Risk Scoring System for Postoperative Pancreatic Fistula.

Kinyas Kartal1, Ahmet Balik2, Ahmet Coker3

  • 1Department of General Surgery, Yeditepe University School of Medicine, 34752 Istanbul, Turkey.

Annali Italiani Di Chirurgia
|February 13, 2026
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Summary

This study introduces a simple risk scoring system for pancreatic surgery to predict postoperative pancreatic fistula (POPF). The system, based on pancreatic texture and duct diameter, helps identify patients at lower risk of developing POPF.

Keywords:
pancreatic fistulapancreatic surgeryrisk scoring system

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Area of Science:

  • Hepatobiliary and Pancreatic Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Postoperative pancreatic fistula (POPF) is a significant complication after pancreatic surgery.
  • Accurate prediction of POPF risk is crucial for patient management.
  • Existing methods may not adequately stratify risk based on intraoperative factors.

Purpose of the Study:

  • To analyze the impact of pancreatic texture and duct diameter on POPF formation.
  • To develop and validate a risk scoring system for predicting POPF.
  • To identify patients at high risk for POPF in pancreatic surgery.

Main Methods:

  • Retrospective analysis of 100 patients undergoing pancreatic surgery.
  • Data collected from seven centers via a web-based module.
  • Risk scoring system developed based on pancreatic tissue texture and duct diameter, with assigned coefficients.

Main Results:

  • 19.5% of 87 evaluable patients developed POPF.
  • The risk scoring system categorized patients into low (25.4%), intermediate (20.6%), and high-risk (54%) groups.
  • High-risk patients had a significantly higher incidence of clinically relevant POPF (9/14).
  • The scoring system demonstrated a sensitivity of 82.35% and specificity of 52.86% for POPF prediction.

Conclusions:

  • A simple intraoperative risk scoring system using pancreatic texture and duct diameter can predict POPF.
  • The system has a high negative predictive value, aiding in identifying patients unlikely to develop POPF.
  • This tool can assist in surgical decision-making and tailoring postoperative care.