Predicting postoperative pancreatic fistula after robotic pancreatoduodenectomy using International Study Group on Pancreatic Surgery and fistula risk scores: European multicentre retrospective cohort study

作者：Anouk M.L.H. Emmen, Mahsoem Ali, Bas Groot Koerkamp, Ugo Boggi, I. Quintus Molenaar, Olivier R. Busch, Thilo Hackert, Luca Moraldi, J. Sven D. Mieog, Daan J. Lips, Olivier Saint‐Marc, Misha Luyer, Susan van Dieren, Geert Kazemier, Felix Nickel, Sebastiaan Festen, Hjalmar C. van Santvoort, Emanuele F. Kauffmann, Roeland F. de Wilde, Mohammad Abu Hilal, Marc G. Besselink · 发表于：BJS Open · 年份：2025 · DOI：10.1093/bjsopen/zraf036 · 被引用次数：10 · 研究领域：Pancreatic and Hepatic Oncology Research、Pancreatitis Pathology and Treatment、Gallbladder and Bile Duct Disorders

BACKGROUND: Postoperative pancreatic fistula represents the leading cause of morbidity and mortality after robotic pancreatoduodenectomy. Various scores have been proposed to stratify patients based on their postoperative pancreatic fistula risk, including three fistula risk scores, and two International Study Group for Pancreatic Surgery scores. This study compares the performance of these scores in patients undergoing robotic pancreatoduodenectomy. METHODS: This is a multicentre European retrospective study in consecutive patients receiving robotic pancreatoduodenectomy for all indications (April 2014 to December 2021). The performance of the International Study Group for Pancreatic Surgery 4-tier (A-D) risk score, and its 3-tier (A-C) modification (International Study Group for Pancreatic Surgery 3-tier), fistula risk scores, alternative-fistula risk scores and the updated alternative-fistula risk scores in postoperative pancreatic fistula grade B/C prediction were compared based on their discrimination (area under the curve), calibration and clinical utility, evaluated through decision curve analyses. RESULTS: Overall, 919 patients undergoing robotic pancreatoduodenectomy were included. The rate of grade B/C postoperative pancreatic fistula was 22.2% (n = 204). The area under the curve for the five scores differed only slightly: International Study Group for Pancreatic Surgery 0.63 (95% confidence interval (c.i.) 0.58 to 0.67), International Study Group for Pancreatic Sur...