Affiliation:
1. Instituto do Câncer do Hospital das Clínicas da Faculdade de Medicina da Univerisdade de São Paulo
2. Hospital das Clínicas HCFMUSP, Universidade de São Paulo
3. Universidade de São Paulo
Abstract
Abstract
Background
Most complications after pancreatoduodenectomy (PD) are due to pancreatic fistula (PF). Therefore, predicting PF is important to individualize treatment. The aim of this study is to develop a preoperative nomogram to predict PF after PD.
Methods
From January 2009 to January 2018, patients that underwent PD were reviewed. After univariate analyses, variables with p < 0.1 were selected for a multivariate analysis. Variables with p < 0.05 were then included in the nomogram, which was internally validated in a different set of patients.
Results
Out of 180 patients evaluated, 19.4% experienced PF. Risk factors for PF were male gender (OR = 2.89), higher BMI (OR = 1.14) and pancreatic duct diameter ≤ 3 mm (OR = 3.52). Weight loss greater than 10% was protective against PF (OR = 0.16). Using these four variables, a preoperative nomogram was built. The nomogram performed well in the validation set (n = 82 patients, 25.6% with PF) with an area under the ROC curve of 0.798.
Conclusions
male gender, main pancreatic duct ≤ 3 mm and higher BMI are risk factors for PF, while weight loss is protective for it. With these variables, it was possible to build a nomogram that accurately predicts the occurrence of PF.
Publisher
Research Square Platform LLC