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. 2021 May 15;21(1):550.
doi: 10.1186/s12885-021-08201-z.

Predictive nomogram for postoperative pancreatic fistula following pancreaticoduodenectomy: a retrospective study

Jian Shen  1 , Feng Guo  1 , Yan Sun  1 , Jingyuan Zhao  1 , Jin Hu  2 , Zunxiang Ke  3 , Yushun Zhang  1 , Xin Jin  4 , Heshui Wu  5
Affiliations

Predictive nomogram for postoperative pancreatic fistula following pancreaticoduodenectomy: a retrospective study

Jian Shen et al. BMC Cancer. .

Abstract

Background: Postoperative pancreatic fistula (POPF) represents the most common complication following pancreaticoduodenectomy (PD). Predictive models are needed to select patients with a high risk of POPF. This study was aimed to establish an effective predictive nomogram for POPF following PD.

Methods: Consecutive patients who had undergone PD between January 2016 and May 2020 at a single institution were analysed retrospectively. A predictive nomogram was established based on a training cohort, and Lasso regression and multivariable logistic regression analysis were used to evaluate predictors. The predictive abilities of the predicting model were assessed for internal validation by the area under the receiver operating characteristic curve (AUC) and calibration plot using bootstrap resampling. The performance of the nomogram was compared with that of the currently used a-FRS model.

Results: A total of 459 patients were divided into a training cohort (n = 302) and a validation cohort (n = 157). No significant difference was observed between the two groups with respect to clinicopathological characteristics. The POPF rate was 16.56%. The risk factors of POPF POPF were albumin difference, drain amylase value on postoperative day 1, pancreas texture, and BMI, which were all selected into a nomogram. Nomogram application revealed good discrimination (AUC = 0.87, 95% CI: 0.81-0.94, P < 0.001) as well as calibration abilities in the validation cohort. The predictive value of the nomogram was better than that of the a-FRS model (AUC: 0.87 vs 0.62, P < 0.001).

Conclusions: This predictive nomogram could be used to evaluate the individual risk of POPF in patients following PD, and albumin difference is a new, accessible predictor of POPF after PD.

Trial registration: This study was registered in the Chinese Clinical Trial Register ( ChiCTR2000034435 ).

Keywords: Albumin; BMI; Drain amylase value; Pancreatic texture; Risk factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The predictive nomogram of postoperative pancreatic fistula
Fig. 2
Fig. 2
The ROC curve and calibration curve of the nomogram
See this image and copyright information in PMC

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References

    1. Tanaka M, Heckler M, Mihaljevic AL, Probst P, Klaiber U, Heger U, Hackert T. Meta-analysis of effect of routine enteral nutrition on postoperative outcomes after pancreatoduodenectomy. Br J Surg. 2019;106(9):1138–1146. doi: 10.1002/bjs.11217. - DOI - PubMed
    1. Tung S, Davis LE, Hallet J, Mavros MN, Mahar AL, Bubis LD, et al. Population-Level Symptom Assessment Following Pancreaticoduodenectomy for Adenocarcinoma. JAMA Surg. 2019:e193348. - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30. doi: 10.3322/caac.21590. - DOI - PubMed
    1. Buchbjerg T, Fristrup C, Mortensen MB. The incidence and prognosis of true duodenal carcinomas. Surg Oncol. 2015;24(2):110–116. doi: 10.1016/j.suronc.2015.04.004. - DOI - PubMed
    1. El NA, Askar W, Atef E, Hanafy EE, Sultan AM, Salah T, et al. Trends and outcomes of pancreaticoduodenectomy for periampullary tumors: a 25-year single-center study of 1000 consecutive cases. World J Gastroenterol. 2017;23(38):7025–7036. doi: 10.3748/wjg.v23.i38.7025. - DOI - PMC - PubMed

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