Fistula risk score-adjusted comparison of postoperative pancreatic fistula following laparoscopic vs open pancreatoduodenectomy

Boram Lee, Yoo Seok Yoon, Chang Moo Kang, Munseok Choi, Jun Suh Lee, Ho Kyoung Hwang, Jai Young Cho, Woo Jung Lee, Ho Seong Han

Research output: Contribution to journalArticlepeer-review

Abstract

Background: To evaluate a risk-adjusted comparison of clinically relevant postoperative pancreatic fistula POPF (CR-POPF) following laparoscopic pancreatoduodenectomy (LPD) vs open pancreatoduodenectomy (OPD) using the fistula risk score (FRS). Methods: We retrospectively analyzed 579 patients who underwent LPD (n = 274) or OPD (n = 305) between 2012 and 2019 at two tertiary hospitals. Using the FRS, the risk was stratified into four categories; negligible, low, intermediate and high risk. Results: The median FRS was significantly higher in the LPD than in the OPD group (5.4 ± 1.2 vs 3.9 ± 1.8, P <.001). The overall incidence of CR-POPF in the LPD vs OPD groups were 16.4% vs 17.7% (P =.187). When POPF risks were stratified by FRS, CR-POPF following LPD vs OPD in patients with low risk (0% vs 6.3%, P =.294), intermediate risk (16.1% vs 22.9%, P =.053) and high risk (33.3% vs 27.3%, P =.577) were not significantly different. Conclusion: Despite a higher risk score in the LPD group, the CR-POPF was similar following both procedures in the unadjusted and FRS-risk-adjusted comparisons. The CR-POPF was more significantly affected by patient risk factors such as the soft pancreas and small pancreatic duct.

Original languageEnglish
JournalJournal of Hepato-Biliary-Pancreatic Sciences
DOIs
Publication statusAccepted/In press - 2020

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology

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