Molasy Bartosz, Zemła Patryk, Mrowiec Sławomir, Kuśnierz Katarzyna
Medical College, Jan Kochanowski University, Kielce, Poland.
Students' Scientific Society of the Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland.
Endokrynol Pol. 2025;76(2):182-190. doi: 10.5603/ep.102243.
Resection of pancreatic neuroendocrine tumors is associated with a high risk of clinically relevant postoperative complications. This study aimed to evaluate and analyze the relationship between selected preoperative risk factors and the occurrence of clinically relevant early postoperative complications, including pancreatic fistulas, after distal pancreatic resections for neuroendocrine tumors.
The analysis included 78 patients who underwent surgery for neuroendocrine tumors of the body or tail of the pancreas. A retrospective analysis was carried out regarding age, sex, comorbidities, preoperative C-reactive protein (CRP) levels, American Society of Anesthesiologists (ASA) score, tumor size, and Wirsung's duct diameter as measured on preoperative computed tomography (CT) scans of the abdomen. The severity of postoperative complications was assessed using the Clavien-Dindo classification, while the International Study Group on Pancreatic Fistula (ISGPF) classification was utilized to evaluate pancreatic fistulas.
Pancreatic fistula was the most common complication and occurred in 42 cases (55.3%). A significant relationship was found between the ASA score and complication severity according to the Clavien-Dindo classification (p = 0.01). Multivariate analyses indicated associations between the occurrence of pancreatic fistula and male sex (OR = 0.17, p = 0.06), age (OR = 0.86, p < 0.01), preoperative CRP level (OR = 1.05, p = 0.01), and ASA score (OR = 125.97, p < 0.01). No significant correlation was identified between tumor size or Wirsung's duct diameter and the occurrence of clinically relevant postoperative complications or pancreatic fistulas (p > 0.05).
The ASA score correlates with the severity of postoperative complications as assessed by the Clavien-Dindo classification. The risk factors for developing B and/or C pancreatic fistulas include age, male sex, elevated preoperative CRP levels, and higher ASA scores.
胰腺神经内分泌肿瘤切除术与临床相关的术后并发症高风险相关。本研究旨在评估和分析所选术前风险因素与神经内分泌肿瘤远端胰腺切除术后临床相关早期术后并发症（包括胰瘘）发生之间的关系。
分析纳入了78例接受胰体或胰尾神经内分泌肿瘤手术的患者。对年龄、性别、合并症、术前C反应蛋白（CRP）水平、美国麻醉医师协会（ASA）评分、肿瘤大小以及术前腹部计算机断层扫描（CT）测量的主胰管直径进行了回顾性分析。术后并发症的严重程度采用Clavien-Dindo分类法评估，而胰瘘则采用国际胰瘘研究组（ISGPF）分类法进行评估。
胰瘘是最常见的并发症，发生在42例（55.3%）患者中。根据Clavien-Dindo分类法，发现ASA评分与并发症严重程度之间存在显著关系（p = 0.01）。多因素分析表明，胰瘘的发生与男性性别（OR = 0.17，p = 0.06）、年龄（OR = 0.86，p < 0.01）、术前CRP水平（OR = 1.05，p = 0.01）和ASA评分（OR = 125.97，p < 0.01）相关。未发现肿瘤大小或主胰管直径与临床相关术后并发症或胰瘘的发生之间存在显著相关性（p > 0.05）。
ASA评分与Clavien-Dindo分类法评估的术后并发症严重程度相关。发生B级和/或C级胰瘘的风险因素包括年龄、男性性别、术前CRP水平升高和较高的ASA评分。
