Predicting pancreatic fistulas after pancreatoduodenectomy: development and internal validation of a new preoperative nomogram
Introduction Pancreatic Fistula (PF) is a major complication following Pancreatoduodenectomy (PD), making its prediction crucial for individualized treatment. The aim of this study is to develop a preoperative nomogram to predict PF after PD. Material and methods From January 200...
| Autores: | , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | Brasil |
| Institución: | Universidade de São Paulo (USP) |
| Repositorio: | Clinics |
| Idioma: | inglés |
| OAI Identifier: | oai:revistas.usp.br:article/240991 |
| Acceso en línea: | https://revistas.usp.br/clinics/article/view/240991 |
| Access Level: | acceso abierto |
| Palabra clave: | Pancreatic fistula Pancreatoduodenectomy Risk factors Multivariate analysis Logistic models |
| Sumario: | Introduction Pancreatic Fistula (PF) is a major complication following Pancreatoduodenectomy (PD), making its prediction crucial for individualized treatment. The aim of this study is to develop a preoperative nomogram to predict PF after PD. Material and methods From January 2009 to January 2018, patients who underwent PD were reviewed. Variables with p < 0.1 from univariate analysis were selected for a multivariate analysis. Variables with p < 0.05 were then included in the nomogram, which was internally validated in a different group of patients. Results 262 patients underwent PD during the period of the study. The risk factors for PF identified in the derivation group were male gender (OR = 2.89), higher BMI (OR = 1.14) and pancreatic duct diameter ≤ 3 mm (OR = 3.52). Preoperative weight loss exceeding 10 % within six months was protective against PF (OR = 0.16). A preoperative nomogram incorporating these four variables was developed and demonstrated good performance in the validation set, with an area under the ROC curve of 0.798. Conclusions male gender, a main pancreatic duct ≤ 3 mm and higher BMI are risk factors for PF, while weight loss is protective. The developed nomogram accurately predicts PF occurrence using these variables. |
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