Total bilirubin level on postoperative day 3 in predicting clinically relevant pancreatic fistula after pancreaticoduodenectomy: a retrospective study
摘要
CR-POPF following PD are very common. The Majority of research on predicting CR-POPF focuses on pre-operation, while there are few indicators for predicting CR-POPF in the early postoperative period. The purpose of this study was to see how TBIL levels on postoperative day 3 predict CR-POPF after PD.
MethodsThe clinical data of 170 patients who had PD in our team between January 2015 and October 2022 were retrospectively analyzed into two groups: the CR-POPF group with a grade B or C pancreatic fistula (n = 37), the no CR-POPF group with a non-pancreatic fistula, and the biochemical fistula patients (n = 133). Univariate and multivariate analyses were used to discover potential determinants of CR-POPF. The predictive value of risk factors was determined by calculating the area under the ROC curve.
ResultsPreoperative variables, including Hb, CRP, TBIL, ALB, pancreatic texture, hemorrhage, duct diameter, and TBIL on postoperative day 3, were found to predict clinically relevant postoperative CR-POPF after PD (p < 0.001). The multivariate logistic regression study revealed that pancreatic texture (p = 0.004), postoperative TBIL (p < 0.001), and preoperative CRP (p = 0.048) are independent risk variables. To predict CR-POPF, the AUC of pancreatic texture, TBIL on the third day of surgery, and preoperative CRP were found to be 0.607, 0.824, and 0.726, respectively.
ConclusionThe TBIL level on postoperative day 3 is a significant predictor of CR-POPF after PD.