Detailed Abstract
[E-poster]
[EP096] Validation of Original, Alternative and Updated Alternative Fistula Risk Scores in Open and Minimally Invasive Pancreatoduodenectomy
Boram LEE1, Yoo-Seok YOON*1, Chang Moo KANG2, Ho-Seong HAN1, Jai Young CHO1, YoungRok CHOI1, Jun Suh LEE1, Ho Kyoung HWANG2, Woo Jung LEE2
1Department of Surgery, Seoul National University Bundang Hospital, Korea
2Department of Surgery, Yonsei University College of Medicine, Korea
Introduction : Several fistula risk score (FRS) models predicting clinically relevant postoperative pancreatic fistula (CR-POPF) have been developed. The purpose of this study was to validate and compare the performance of the original (o-FRS), alternative (a-FRS) and updated alternative FRS (ua-FRS) after open pancreatoduodenectomy (OPD) and minimally invasive pancreatoduodenectomy (MIPD).
Methods : From January 2012 to February 2019, 597 consecutive patients underwent PD (305 OPD, 274 MIPD) in two centers. POPF was defined and classified according to the 2016 International Study Group for Pancreatic Fistula. Model performance was assessed using the are under the receiver operating curve (AUC).
Results : CR-POPF occurred in 17.7% after OPD and 16.4% after MIPD. The a-FRS had better discrimination (AUC 0.71, 95% confidence interval [CI], 0.64-0.78) than o-FRS and ua-FRS in the OPD group, whereas the ua-FRS (0.69, 0.60-0.78) had better discrimination than o-FRS and a-FRS in the MIPD group. Among risk factors suggested in 3 FRS systems, the male (hazard ration (HR) 2.47, 95% CI 1.21-5.06, P=0.013), pancreas texture (6.179, 2.78-13.7, P<0.001) and pancreas duct size (0.82, 0.69-0.95, P=0.017) were identified for CR-POPF risk factors in OPD group. In MIPD group, the pancreatic texture (4.77, 1.65-13.8, P<0.001) and duct size (0.77, 0.63-0.94, P=0.015) were identified for CR-POPF risk factors.
Conclusions : Three FRS models had different predicting power for CR-POPF depending on the type of surgery. Only the pancreas texture and pancreas duct size were valid risk factors for both of OPD and MIPD. A large-scale study is required to develop a POPF predicting mode applicable to both of OPD and
Methods : From January 2012 to February 2019, 597 consecutive patients underwent PD (305 OPD, 274 MIPD) in two centers. POPF was defined and classified according to the 2016 International Study Group for Pancreatic Fistula. Model performance was assessed using the are under the receiver operating curve (AUC).
Results : CR-POPF occurred in 17.7% after OPD and 16.4% after MIPD. The a-FRS had better discrimination (AUC 0.71, 95% confidence interval [CI], 0.64-0.78) than o-FRS and ua-FRS in the OPD group, whereas the ua-FRS (0.69, 0.60-0.78) had better discrimination than o-FRS and a-FRS in the MIPD group. Among risk factors suggested in 3 FRS systems, the male (hazard ration (HR) 2.47, 95% CI 1.21-5.06, P=0.013), pancreas texture (6.179, 2.78-13.7, P<0.001) and pancreas duct size (0.82, 0.69-0.95, P=0.017) were identified for CR-POPF risk factors in OPD group. In MIPD group, the pancreatic texture (4.77, 1.65-13.8, P<0.001) and duct size (0.77, 0.63-0.94, P=0.015) were identified for CR-POPF risk factors.
Conclusions : Three FRS models had different predicting power for CR-POPF depending on the type of surgery. Only the pancreas texture and pancreas duct size were valid risk factors for both of OPD and MIPD. A large-scale study is required to develop a POPF predicting mode applicable to both of OPD and
SESSION
E-poster
E-Session 7/27 ~ 7/29 ALL DAY