Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 172] Predictors of Post-Operative Pancreatic Fistula after Pancreatoduodenectomy in a Tertiary Care Center in a Low- to Middle-Income Country
RAVI SHANKAR BISWAS 1, SULAGNA DAS 2, DIPANKAR RAY 1, DEBASISH GHOSH 3, DILIP KUMAR 1, MD BASIR AHMED 1, SOURAV CHOWDHURY 1
1 Department of Surgical Gastroenterology, Medical College Hospital, Kolkata, INDIA, 2 Department of Community Medicine, Burdwan Medical College, Burdwan, INDIA, 3 Department of Anesthesiology And Critical Care Medicine, Medical College Hospital, Kolkata, INDIA
Background : Post-operative pancreatic fistula (POPF) is a common and concerning complication of pancreatoduodenectomy (PD). Even in high-volume centers, non-modifiable factors such as the texture of the pancreas, ductal diameter, and pancreatic pathology contribute to its prevalence in the plateau phase. Intraoperatively placed abdominal drains have their own complications, necessitating early removal; however, weighing against the risk of POPF. As a result, predictors of POPF such as the Fistula Risk Score (FRS), C-reactive protein on post-operative day 2 (CRP-2), and post-operative hyperamylasemia (POH) have evolved. Our study aims to evaluate and identify the best POPF predictor.
Methods : This retrospective study analyzed 150 patients who underwent PD between January 2021 and December 2023. A Chi-square test was done to identify the predictors of POPF, which were analyzed with univariate and multivariate logistic regression analyses.
Results : The mean age of the study population is 61 years, with a male preponderance. Thirty-three percent had biochemical leaks, while 12% and 5% had grade B and C POPF, respectively. POH on post-operative day 1 (POH-1), POH-2, and CRP-2 (>180 mg/l) were the significant predictors for POPF. The receiver operating characteristic (ROC) curve for predictors of POPF following PD shows POH-1 had the highest area under curve (AUC) value compared to POH-2, CRP-2, and FRS. The cutoff value of serum amylase was 174.5 (POH-1)(AUC 0.86, sensitivity 80.0%, specificity 57.2%, and accuracy 64.6%), compared to 143.5 (POH-2)(AUC 0.80, sensitivity 80.0%, specificity 63.3%, and accuracy 63.6%).
Conclusions : POH-1 has the highest predictive value for POPF compared to POH-2, CRP-2, and FRS.
Methods : This retrospective study analyzed 150 patients who underwent PD between January 2021 and December 2023. A Chi-square test was done to identify the predictors of POPF, which were analyzed with univariate and multivariate logistic regression analyses.
Results : The mean age of the study population is 61 years, with a male preponderance. Thirty-three percent had biochemical leaks, while 12% and 5% had grade B and C POPF, respectively. POH on post-operative day 1 (POH-1), POH-2, and CRP-2 (>180 mg/l) were the significant predictors for POPF. The receiver operating characteristic (ROC) curve for predictors of POPF following PD shows POH-1 had the highest area under curve (AUC) value compared to POH-2, CRP-2, and FRS. The cutoff value of serum amylase was 174.5 (POH-1)(AUC 0.86, sensitivity 80.0%, specificity 57.2%, and accuracy 64.6%), compared to 143.5 (POH-2)(AUC 0.80, sensitivity 80.0%, specificity 63.3%, and accuracy 63.6%).
Conclusions : POH-1 has the highest predictive value for POPF compared to POH-2, CRP-2, and FRS.
SESSION
E-poster
E-Session 03/21 ALL DAY