Comparing the distal pancreatectomy fistula risk score (D‐FRS) and DISPAIR‐FRS for predicting pancreatic fistula after distal pancreatectomy

Abstract

AbstractBackgroundsDistal pancreatectomy fistula risk score (D‐FRS) and DISPAIR‐FRS has not been widely validated for predicting postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP).MethodsWe retrospectively analysed 104 patients undergoing DP. The predictive value of the D‐FRS and DISPAIR‐FRS were compared. Risk factors associated with POPF were investigated by multivariate analysis.ResultsOf the 104 patients, 23 (22.1%) were categorized into the POPF group (all grade B). The areas under the ROC (AUCs) of the D‐FRS (preoperative), D‐FRS (intraoperative), and DISPAIR‐FRS were 0.737, 0.809, and 0.688, respectively. Stratified by the D‐FRS (preoperative), the POPF rates in low‐risk, intermediate‐risk, and high‐risk groups were 5%, 22.6%, and 36.4%, respectively. By the D‐FRS (intraoperative), the POPF rates in low‐risk, intermediate‐risk, and high‐risk groups were 8.8%, 47.1%, and 47.4%, respectively. By the DISPAIR‐FRS, the POPF rates in low‐risk, intermediate‐risk, and extreme‐high‐risk groups were 14.8%, 23.8% and 62.5%, respectively. Body mass index and main pancreatic duct diameter were independent risk factors of POPF both in preoperative (P = 0.014 and P = 0.033, respectively) and intraoperative (P = 0.015 and P = 0.039) multivariate analyses.ConclusionBoth the D‐FRS (preoperative), D‐FRS (intraoperative), and DISPAIR‐FRS has good performance in POPF prediction after DP. The risk stratification was not satisfactory in current Asian cohort.