肝胆胰外科杂志2025，Vol.37Issue(6)：386-393,8.DOI:10.11952/j.issn.1007-1954.2025.06.006
胰腺切除术后胰瘘基于CT及临床特征的术前预测及风险评估
Preoperative prediction and risk assessment of pancreatic fistula after pancreatectomy based on CT and clinical features
马倩 1陈海燕 2徐国徽 3宋子阳 2董锐增 4江海涛2
作者信息
- 1. 浙江省肿瘤医院 中国科学院杭州医学研究所 放射科,浙江 杭州 310022||温州医科大学研究生院,浙江 温州 325000
- 2. 浙江省肿瘤医院 中国科学院杭州医学研究所 放射科,浙江 杭州 310022
- 3. 温州医科大学研究生院,浙江 温州 325000
- 4. 浙江省肿瘤医院 中国科学院杭州医学研究所 肝胆胰外科,浙江 杭州 310022
- 折叠
摘要
Abstract
Objective To explore the application value of preoperative CT features and clinical features that are easily available in clinical diagnosis and treatment in predicting pancreatic fistula after pancreatectomy,and to establish a risk scoring system.Methods A retrospective study was conducted on 178 patients who underwent pancreaticoduodenectomy or distal pancreatectomy at Zhejiang Cancer Hospital from Jan.2017 to Dec.2022.Patients were divided into the clinically relevant postoperative pancreatic fistula(CR-POPF)group and the non-CR-POPF group,with 89 patients in each group.Preoperative CT features and clinical features were collected for each patients.Univariate correlation analysis was performed on all variables,and variables that may be related to CR-POPF were subsequently included in a multivariate Logistic regression model.A radiological prediction model was established according to preoperative CT features,a clinical prediction model was established according to preoperative clinical features and a combined prediction model was established according to preoperative CT and clinical feature.The predictive performance of the models was evaluated with receiver operating characteristic(ROC)curves.A risk scoring system was established based on risk prediction factors.Results The AUC of the radiological prediction model was 0.837(95%CI 0.776 to 0.897),with the sensitivity of 0.899 and specificity of 0.663;The AUC of the clinical prediction model was 0.764(95%CI 0.693 to 0.835),with the sensitivity of 0.787 and specificity of 0.652;The AUC of the combined prediction model was 0.877(95%CI 0.824 to 0.930),with the sensitivity of 0.854 and specificity of 0.809.Based on the combined prediction model,four risk groups were identified:negligible-risk group,low-risk group(<10%),moderate-risk group(10%to 60%),and high-risk group(>60%).Conclusion This study suggests that preoperative CT features and clinical features are useful for evaluating the risk of CR-POPF after pancreaticoduodenectomy or distal pancreatectomy.关键词
术后胰瘘/临床相关/胰腺切除术/胰腺远端切除术/术前CT/术前临床特征/预测模型/风险分层Key words
postoperative pancreatic fistula/clinically relevant/pancreatectomy/distal pancreatectomy/preoperative ctT/preoperative clinical features/prediction model/risk stratification分类
临床医学引用本文复制引用
马倩,陈海燕,徐国徽,宋子阳,董锐增,江海涛..胰腺切除术后胰瘘基于CT及临床特征的术前预测及风险评估[J].肝胆胰外科杂志,2025,37(6):386-393,8.
