Work

Total bilirubin level on postoperative day 3 in predicting clinically relevant pancreatic fistula after pancreaticoduodenectomy: a retrospective study

Year: 2025

Type: article

Abstract: BACKGROUND: 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. METHODS: The 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. RESULTS: Preoperative 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. CONCLUSION: The TBIL level on postoperative day 3 is a significant predictor of CR-POPF after PD.

Source: BMC Surgery

DOI: 10.1186/s12893-025-03205-z