Clinical evaluation of preoperative pancreatic fistula scoring system in prediction of postoperative pancreatic fistula of pancreaticoduodenectomy

Abstract

Objective To explore the value of preoperative pancreatic fistula scoring system in prediction of the postoperative pancreatic fistula (POPF) of pancreaticoduodenectomy(PD). Methods 491 patients from Jan 2012 to Jan 2017 undergoing PD were retrospectively analyzed, in reference to independent risk factors for POPF. At the same time, the sensitivity, specificity and accuracy of National Cancer Center Hospital score system (NCCH score system) for preoperative pancreatic fistula score system were evaluated prospectively from Jan 2015 to Jan 2017. Results 90 patients were diagnosed as having POPF, including 56 in grade A, 26 in grade B and 8 in grade C. The multivariate logistic regression analysis showed that the gender (male), the pancreatic texture (soft), the non-pancreatic cancer and the main pancreatic duct diameter (smaller than 3 mm) were the independent risk factor for POPF. The results of ROC curve analysis showed that the sensitivity and specificity of the NCCH predictive scoring system were 93.1% and 76.9%, respectively.The area under the curve was 0.910 (95%CI: 0.857-0.962). Conclusions The NCCH score systems can predict the POPF accurately. Key words: Pancreaticoduodenectomy; Pancreatic fistula; Risk factors; Predictive score systems