A novel postoperative inflammatory score predicts postoperative pancreatic fistula after pancreatic resection

Aim: The aim of this study was to characterize a high-risk group of patients for pancreatic fistula (PF) after pancreatic resection using postoperative clinical variables of patients. Patients and Methods: The retrospective study included 297 patients who underwent pancreatic resection between January 2001 and December 2011. We examined the relationship between perioperative findings and the incidence of postoperative PF (POPF) among patients who underwent pancreatic resection between 2001 and 2009 (early period). Next, patients were stratified into three groups using serum albumin and CRP on postoperative day 1 (score 0: albumin ≥2.7 g/dl and CRP ≤10 mg/dl; score 1: albumin <2.7 g/dl or CRP >10 mg/dl; score 2: albumin <2.7 g/dl and CRP >10 mg/dl) as postoperative inflammatory score (PIS). We examined perioperative findings including PIS and POPF among patients who underwent pancreatic resection between 2010 and 2011 (late period). Results: In univariate and multivariate analyses, male gender (p=0.032), serum albumin on postoperative day 1 (p=0.024) and serum CRP on postoperative day 1 were identified as independent risk factors for POPF in early-period patients. In univariate and multivariate analyses, postoperative hospital stay (p=0.009) and PIS (score 1: p=0.005, score 2: p=0.017) were identifical as independent risk factors for POPF in late-period patients. Conclusion: We found a novel PIS to indicate risk for PF after elective pancreatic resection.