[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-398240-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-398240-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","a-prospectively-validated-clinical-risk-score-accurately-predicts-pancreatic-fistula-after-pancreatoduodenectomy","A Prospectively Validated Clinical Risk Score Accurately Predicts Pancreatic Fistula after Pancreatoduodenectomy","","Clinically relevant postoperative pancreatic fistulas (CR-POPF) remain a serious risk after pancreatic resection, yet preoperative risk assessment is often inadequate. This study evaluated recognized intraoperative risk factors during pancreaticoduodenectomy to develop and prospectively validate a risk prediction tool. A 10-point Fistula Risk Score stratified patients into negligible, low, intermediate, and high-risk ranges. Scores correlated strongly with fistula development, with no CR-POPF at 0 points and all patients affected at scores of 9–10. The tool also separated key clinical and economic outcomes and was easy to learn and deploy.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/a-prospectively-validated-clinical-risk-score-accurately-predicts-pancreatic-fistula-after-pancreatoduodenectomy/398240/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/a-prospectively-validated-clinical-risk-score-accurately-predicts-pancreatic-fistula-after-pancreatoduodenectomy/398240.png","ImageObject",300,407,{"name":42,"@type":43},"percent12345","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-04","2026-09-27",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",16,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the purpose of developing the Fistula Risk Score?","Question",{"text":63,"@type":64},"To create and prospectively validate a tool that predicts clinically relevant postoperative pancreatic fistula (CR-POPF) using intraoperative assessment during pancreaticoduodenectomy.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which intraoperative factors were evaluated for CR-POPF risk?",{"text":68,"@type":64},"Risk factors included small duct, soft pancreas, high-risk pathology, and excessive blood loss, assessed during pancreaticoduodenectomy.",{"name":70,"@type":61,"acceptedAnswer":71},"How did the risk score relate to CR-POPF occurrence?",{"text":72,"@type":64},"Risk scores strongly correlated with CR-POPF development; patients with 0 points had no CR-POPF, while patients with scores of 9 or 10 developed fistulas.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},398240,1790580319,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146,"preview_page_count":4},1099529851338,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","|  |  |  |\n| --- | --- | --- |\n|  | ORIGINAL SCIENTIFIC ARTICLES |  |\n| A Prospectively Validated Clinical Risk Score Accurately Predicts Pancreatic Fistula after Pancreatoduodenectomy\u003Cbr>Mark P Callery, MD, FACS, Wande B Pratt, MD, MPH, Tara S Kent, MD, FACS, Elliot L Chaikof, MD, PhD, FACS, Charles M Vollmer Jr, MD, FACS |  |  |\n| BACKGROUND: Clinically relevant postoperative pancreatic fistulas (CR-POPF) are serious inherent risks of pancreatic resection. Preoperative CR-POPF risk assessment is currently inadequate and rarely disqualifies patients who need resection. The best evaluation of risk occurs intraoperatively, and should guide fistula prevention and response measures thereafter. We sought to develop a risk prediction tool for CR-POPF that features intraoperative assessment and reveals associated clinical and economic significance.\u003Cbr>STUDY DESIGN: Based on International Study Group of Pancreatic Fistula classification, recognized risk factors for CR-POPF (small duct, soft pancreas, high-risk pathology, excessive blood loss) were evaluated during pancreaticoduodenectomy. An optimal risk score range model, selected from\u003Cbr>3 different constructs, was first derived (n ¼ 233) and then validated prospectively (n ¼ 212). Clinical and economic outcomes were evaluated across 4 ranges of scores (negligible risk, 0 points; low risk, 1 to 2; intermediate risk, 3 to 6; high risk, 7 to 10) .\u003Cbr>RESULTS: Clinically relevant postoperative pancreatic fistulas occurred in 13% of patients. The incidence\u003Cbr>was greatest with excessive blood loss. Duct size \u003C5 mm was associated with increased fistula rates that rose with even smaller ducts. These factors, together with soft pancreatic parenchyma and certain disease pathologies, afforded a highly predictive 10-point Fistula Risk Score. Risk scores strongly correlated with fistula development(p \u003C 0.001). Notably, patients with scores of\u003Cbr>0 points never developed a CR-POPF, while fistulas occurred in all patients with scores of 9 or\u003Cbr>10. Other clinical and economic outcomes segregated by risk profile across the 4 risk strata. CONCLUSIONS: A simple 10-point Fistula Risk Score derived during pancreaticoduodenectomy accurately\u003Cbr>predicts subsequent CR-POPF. It can be readily learned and broadly deployed. This prediction tool can help surgeons anticipate, identify, and manage this ominous complication from the outset. (J Am Coll Surg 2013;216:1e14. 􀀁 2013 by the American College of Surgeons) |  |  |\n\nCME questions for this article available at [http://jacscme.facs.org](http://jacscme.facs.org)  \nDisclosure Information: Authors have nothing to disclose. Timothy J Eberlein, Editor-in-Chief, has nothing to disclose.  \nPresented at the American College of Surgeons 97th Annual Clinical Congress, San Francisco, CA, October 2011 .  \nReceived July 16, 2012; Revised September 5, 2012; Accepted September 5, 2012.  \nFrom the Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (Callery, Kent, Chaikof); the Department of Surgery, Barnes Jewish Hospital, Washington University School of Medicine, St Louis, MO (Pratt); and the Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, PA (Vollmer) .  \nCorrespondence address: Charles M Vollmer Jr, MD, FACS, Department of Surgery, University of Pennsylvania School of Medicine, 3400 Spruce St, 4th Floor, Silverstein Pavilion, Philadelphia, PA [19104. email:](19104. email:)[ ](19104. email:)[Charles.Vollmer@uphs.upenn.edu](Charles.Vollmer@uphs.upenn.edu)  \nDespite advancements in operative technique and improvements in postoperative outcomes, pancreatic fistula is widely considered to be the most common and troublesome complication after pancreatic resection. It represents the factor most often linked with postoperative mortality, certain complications such as delayed gastric emptying, longer hospital stays, readmissions, and increased costs. Furthermore, i","cbCaivXO4w4WPONH","https://ap.wps.com/l/cbCaivXO4w4WPONH","pdf",264944,14,"English","# Background\n# Study design\n# Results\n# Conclusions","[{\"question\":\"What was the purpose of developing the Fistula Risk Score?\",\"answer\":\"To create and prospectively validate a tool that predicts clinically relevant postoperative pancreatic fistula (CR-POPF) using intraoperative assessment during pancreaticoduodenectomy.\"},{\"question\":\"Which intraoperative factors were evaluated for CR-POPF risk?\",\"answer\":\"Risk factors included small duct, soft pancreas, high-risk pathology, and excessive blood loss, assessed during pancreaticoduodenectomy.\"},{\"question\":\"How did the risk score relate to CR-POPF occurrence?\",\"answer\":\"Risk scores strongly correlated with CR-POPF development; patients with 0 points had no CR-POPF, while patients with scores of 9 or 10 developed fistulas.\"}]","A Prospectively Validated Clinical Risk Score Accurately Predicts Pancreatic Fistula after Pancreatoduodenectomy | PDF",1790474499,35]