Roberts et al developed a score for predicting a pancreatic fistula after a pancreaticoduodenectomy. This can help to identify a patient who may benefit from more aggressive management. The authors are from University Hospitals Birmingham.
Patient selection: pancreaticoduodenectomy
Outcome: pancreatic fistula
Parameters:
(1) body mass index (BMI)
(2) pancreatic duct width in mm in contrast-enhanced CT
X =
= (0.107 * (BMI)) - (0.404 * (pancreatic duct width)) - 3.206
percentage of patients with pancreatic fistula =
= 1 / (1 + EXP((-1) * X))
The risk increases with increasing BMI and decreases with the diameter of the pancreatic duct.
Additional factors from postoperative analysis:
(1) perirenal fat thickness
(2) diagnosis (duodenal lesion, dysplastic ampulla, parenchymal pancreatic disease other than pancreatic or ampullary cancer)
