Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 141] Identifying Clinically Relevant Values for Postoperative Pancreatic Fistula: Towards a Redefined Grading System
Hochang CHAE 1, Hyung Seok KIM 1, Soo Yeun LIM 1, Hye Jeong JEONG 1, So Jeong YOON 1, Hongbeom KIM 1, In Woong HAN 1, Jin Seok HEO 1, Sang Hyun SHIN 1
1 Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, REPUBLIC OF KOREA
Background : Currently, postoperative pancreatic fistula (POPF) criteria includes biochemical leak (BCL), but there is no clinical significance. We conducted this study to identify clinically relevant values for POPF.
Methods : We retrospectively analyzed patient who underwent pancreatic surgery from January 2018 to December 2022, at Samsung Medical Center. Laboratory test results and postoperative were collected for the analysis
Results : A total of 1,168 patients were included in this study and 92 patients had clinically relevant postoperative pancreatic fistula (CR-POPF). Patients who underwent pancreaticoduodenectomy (PD) had 72 cases of CR-POPF, while those who underwent distal pancreatectomy (DP) had 16 cases. The odds ratio (OR) for the drain/serum amylase ratio on POD 3 was 1.007, and the calculated AUC was 0.8298. In PD group, OR for the drain/serum amylase ratio on POD 3 was 10.22, and AUC was 0.8499. In DP group, OR was 1.004, and AUC was 0.8593. Exploring cut-off values for predicting CR-POPF, a POD 3 ratio of 5 had a sensitivity of 0.89 for predicting CR-POPF. In the PD group, a ratio of 5 had a sensitivity of 0.88, and in the DP group, a ratio of 7 had a sensitivity of 0.93 for predicting CR-POPF.
Conclusions : Applying a ratio of drain to serum amylase for 5 would be the clinically relevant value for postoperative pancreatic fistula. Different criteria could be applied for pancreaticoduodenectomy and distal pancreatectomy, and grading of POPF should be based on these criteria
Methods : We retrospectively analyzed patient who underwent pancreatic surgery from January 2018 to December 2022, at Samsung Medical Center. Laboratory test results and postoperative were collected for the analysis
Results : A total of 1,168 patients were included in this study and 92 patients had clinically relevant postoperative pancreatic fistula (CR-POPF). Patients who underwent pancreaticoduodenectomy (PD) had 72 cases of CR-POPF, while those who underwent distal pancreatectomy (DP) had 16 cases. The odds ratio (OR) for the drain/serum amylase ratio on POD 3 was 1.007, and the calculated AUC was 0.8298. In PD group, OR for the drain/serum amylase ratio on POD 3 was 10.22, and AUC was 0.8499. In DP group, OR was 1.004, and AUC was 0.8593. Exploring cut-off values for predicting CR-POPF, a POD 3 ratio of 5 had a sensitivity of 0.89 for predicting CR-POPF. In the PD group, a ratio of 5 had a sensitivity of 0.88, and in the DP group, a ratio of 7 had a sensitivity of 0.93 for predicting CR-POPF.
Conclusions : Applying a ratio of drain to serum amylase for 5 would be the clinically relevant value for postoperative pancreatic fistula. Different criteria could be applied for pancreaticoduodenectomy and distal pancreatectomy, and grading of POPF should be based on these criteria
SESSION
E-poster
E-Session 03/21 ALL DAY