TY  - JOUR
AU  - Kang, Jae Seung
AU  - Park, Taesung
AU  - Han, Youngmin
AU  - Lee, Seungyeon
AU  - Kim, Jae Ri
AU  - Kim, Hongbeom
AU  - Kwon, Wooil
AU  - Kim, Sun-Whe
AU  - Heo, Jin Seok
AU  - Choi, Seong Ho
AU  - Choi, Dong Wook
AU  - Kim, Song Cheol
AU  - Hong, Tae Ho
AU  - Yoon, Dong Sup
AU  - Park, Joon Seong
AU  - Park, Sang Jae
AU  - Han, Sung-Sik
AU  - Choi, Sae-Byeol
AU  - Kim, Joo Seop
AU  - Lim, Chang-Sup
AU  - Jang, Jin-Young
PY  - 2019
TI  - Clinical validation of scoring systems of postoperative pancreatic fistula after pancreatoduodenectomy: applicability to Eastern cohorts?
JF  - Hepatobiliary Surgery and Nutrition; Vol 8, No 3 (June 01, 2019): Hepatobiliary Surgery and Nutrition (Special Focus on Antibodies and Liver Transplantation: Part 3)
Y2  - 2019
KW  - 
N2  - Background: Although several prediction models for the occurrence of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD) exist, all were established using Western cohorts. Large-scale external validation studies in Eastern cohorts that consider demographic variables including lower body mass index (BMI) are scarce. The purpose of this study was to externally validate POPF prediction models using nationwide large-scale Korean cohorts.  Methods: Nine tertiary university hospitals in the Republic of Korea participated. Patients’ preoperative characteristics, intraoperative factors, and pathologic findings were evaluated. POPF grades were determined according to the 2016 International Study Group on Pancreatic Surgery definition. Three POPF risk models (Callery, Roberts, and Mungroop) were selected for external validation.  Results: A total of 1,898 PD patients were enrolled. A non-pancreatic disease diagnosis [hazard ratio (HR), 1.856; 95% confidence interval (CI), 1.223–2.817; P=0.004), higher preoperative BMI (HR, 1.069; 95% CI,  1.019–1.121; P=0.006), and soft pancreatic texture (HR, 1.859; 95% CI, 1.264–2.735; P=0.002) were independent risk factors for clinically relevant POPF (CR-POPF). The area under the receiver operating characteristic curve (AUC) values were 0.61, 0.64, and 0.63 on the Callery, Roberts, and Mungroop models, respectively; all were lower than those published in each external validation study.  Conclusions: Western POPF prediction models performed less well when applied to Korean cohorts. Thus, a large-scale Eastern-specific and externally validated POPF prediction model is needed.
UR  - https://hbsn.amegroups.org/article/view/25110