Publication: Prediction of Postoperative Major Complications in Pancreaticoduodenectomy -a Prospective Comparative Analysis of Braga and WHipple-ABACUS Scores
Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Major complications following pancreaticoduodenectomy have a severely deleterious
effect on postoperative course, rather than just occurrence of pancreatic fistula.
Surgical risk stratification with Braga and WHipple-ABACUS have been proposed and
validated.
Objective
The study aimed at comparing the Braga and WHipple-ABACUS scores for prediction
of major complications following pancreaticoduodenectomies.
Method
This was a prospective observational study at the Tribhuvan University Teaching
Hospital from February 2018 to April 2019. After ethical approval, all consecutive 41
patients who underwent pancreaticoduodenectomies were included. Each patient
was graded in Braga and WHipple-ABACUS scores. Perioperative events occurring
over 30 days were graded as per Clavien -Dindo complications for pancreatic
surgery. The predictive value of the scores were assessed using a receiver operating
characteristic curve analysis. The categorical data were compared using the Pearson
χ2 test or Fisher’s exact test.
Result
Over period of 14 months, total of 41 patients (M:F=2.15:1) with median age of 58
years (range, 21-86) underwent pancreatoduodenectomy. The mean scores were
Braga (4.6±3.1) and WHipple-ABACUS (1.8±1.6). Major complications over 30 days
were developed in 11 patients with five mortality. There were significant differences
in mean values of Braga score (7.0±3.4 vs 3.7±2.6, p-value=0.02) and WHipple-
ABACUS score (3.2±1.8 vs 1.3±1.3, p-value=0.01) in patients with major complications
to those without respectively. The area under curves for Braga and WHipple-ABACUS
scores were 0.800 and 0.779 respectively.
Conclusion
Both WHipple-ABACUS and Braga scores are easy to calculate and predict
the development of major complications significantly in patients undergoing
pancreatoduodenectomy.
KEY WORDS
Braga score, Pancreaticoduodenectomy, Post-operative pancreatic fistula, WHipple-
ABACUS score
Description
Sah DN,1 Lakhey PJ,2 Bhandari RS2
1Department of General Surgery
Birat Medical College Teaching Hospital
Biratnagar, Morang, Nepal
2Department of Surgical Gastroenterology
Tribhuvan University Teaching Hospital
Maharajgunj, Kathmandu, Nepal
Keywords
Braga score, Pancreaticoduodenectomy, Post-operative pancreatic fistula, WHipple- ABACUS score