BACKGROUND: Early diagnosis of postoperative pancreatic ifstula (POPF) is important for proper interventions. The pre-operative, intraoperative and early postoperative biochemical markers have predictive value of POPF. The present study was to evaluate several simple biochemical parameters in the pre-diction of POPF.
METHODS: Patients who underwent pancreaticoduodenec-tomy in our center between 2006 and 2015 were reviewed ret-rospectively. Preoperative and early postoperative biochemi-cal parameters were evaluated. Additionally, the relationship between POPF and pH and lactate level at the end of surgery were analyzed, and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width-to-platelet ratio (RPR) were calculated for postoperative days (PODs) 1 and 3. Diagnosis and grading of POPF were per-formed according to the standards of the International Study Group on Pancreatic Fistula. The patients were divided into two groups: Group 1 with no ifstula or grade-A ifstula; group 2 with grade-B or -C ifstula. These simple biochemical markers were then compared between the two groups.
RESULTS: Serum amylase level was signiifcantly higher at POD3, and pH level was signiifcantly lower at the end of op-eration in group 2 compared with those in group 1. However, the serum amylase was below the upper limit of normal serum level and therefore, the difference was not signiifcant in clini-cal practice. Receiver operating charecteristic curve analysis showed that pH level was a reliable predictor of POPF (area under the curve: 0.713; 95% CI: 0.573-0.853).
CONCLUSIONS: A low pH level at the end of pancreaticoduo-denectomy was a risk factor of POPF. NLR, PLR, and RPR had no predictive value of POPF after pancreaticoduodenectomy.