Using scores for predicting the risk of postoperative pancreatic fistula

Aim. To evaluate the prognostic significance and clinical efficacy of preoperative risk scores in pancreatic fistula after pancreatic duodenal resection. Material and methods . The study included 60 patients with pancreatic and periampular malignancies who underwent pancreatoduodenal resection with Blumgart pancreato-jejunal anastomosis from 2022 to 2024. Postoperative pancreatic fistulas were diagnosed according to the criteria of the International Study Group of Pancreatic Surgery (ISGPS). The ROC analysis and diagnostic efficacy indicators were used to assess the prognostic accuracy. Results. Ten patients (16.67%) were diagnosed with postoperative pancreatic fistula. The ROC analysis showed comparable areas under the curve (AUC): alternative Fistula Risk Score (a-FRS) – 0.692; updated alternative FRS (ua-FRS) – 0.636; Kantor score – 0.656; Lapshyn score – 0.649. Lapshyn and a-FRS scores demonstrated the highest sensitivity (70%); while the ua-FRS score had the highest specificity (82%). The positive prognostic value of all scores remained low, with wide confidence intervals. Conclusion. Preoperative stratification of pancreatic fistula risk using scores may be a useful tool for individualizing surgical tactics. Despite moderate prognostic accuracy, their use promotes clinical alertness and a personalized approach. Prospective studies in large patient groups are needed to further improve prediction models.