Pancreatic Fistula Risk Score
Pancreatic Fistula Risk Score
Gland Texture
Pathology
Pancreatic Duct Diameter
Intraoperative Blood Loss
Fistula Risk Score:
–
Score: 0
Default scoring assumes 0 for un-set fields.
Predicts postoperative pancreatic fistula, based on intraoperative findings, after pancreatic resection.
When to Use
Patients undergoing pancreatic resection.
Formula
Addition of the selected points: Variable Points Gland texture Firm 0 Soft 2 Pathology Pancreatic adenocarcinoma or pancreatitis 0 Any other pathology (e.g. ampullary, duodenal, cystic, islet cell) 1 Pancreatic duct diameter ≥5 mm 0 4 mm 1 3 mm 2 2 mm 3 ≤1 mm 4 Intraoperative blood loss ≤400 mL 0 401-700 mL 1 701-1,000 mL 2 >1,000 mL 3
Advice
Consider preventative measures in patients at high risk for fistula (e.g. anastomotic stents, prophylactic octreotide, tissue sealants).
More Information
Interpretation: Pancreatic Fistula Risk Score Risk group Rate of clinically relevant postoperative pancreatic fistula* 0 Negligible ~0% 1-2 Low 6.6% 3-6 Intermediate 12.9% 7-10 High 28.1% *Defined as clinically apparent symptomatic fistulas requiring diagnostic evaluation and therapeutic intervention, or those causing sepsis and/or organ dysfunction (need for critical care). Figures from Miller et al 2014 .