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March 18, 2026Surgery in Practice and ScienceOpen Access

Postoperative Day 3 Biomarkers for Risk Stratification and Prediction of Clinically Relevant Pancreatic Fistula After Pancreaticoduodenectomy: A Retrospective Cohort Study

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Authors

CTChiao-Yu TsaiWLWei-Hsun LuCWChih-Jung Wang

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Overview

A retrospective cohort study evaluates biomarkers for predicting pancreatic fistula risk, suggesting improved management strategies.

Key Points

  • This study aims to assess the effectiveness of postoperative day 3 biomarkers in predicting clinically relevant pancreatic fistula (CR-POPF) after pancreaticoduodenectomy.
  • Retrospective analysis of 439 patients who underwent pancreaticoduodenectomy
  • Measurement of drain fluid amylase (DFA) and serum C-reactive protein (CRP) on postoperative days 1, 3, and 7
  • Logistic regression to identify CR-POPF risk factors
  • Receiver operating characteristic curves to evaluate predictive performance.
  • CR-POPF occurred in 12.5% of patients (55 out of 439)
  • Combined POD3 DFA ≤300 U/L and CRP ≤200 mg/L provided high sensitivity (96.2%) and negative predictive value (98.8%)
  • Identified four distinct risk categories for CR-POPF with rates between 1.2% and 31.6%
  • Prior criteria (DFA >5000 U/L on POD1) showed lower sensitivity (56.4%).

Cite This Study

Tsai et al. (2026) studied this question.

synapsesocial.com/papers/69ba41e04e9516ffd37a1deahttps://doi.org/10.1016/j.sipas.2026.100340
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Postoperative day 3 drain amylase versus fistula risk score: predicting clinically relevant postoperative pancreatic fistula following pancreatico-duodenectomy2019 · 6 citations
  2. 2Dynamic Assessment of Drain Fluid Amylase Estimates the Risk of CR-POPF Following Pancreatoduodenectomy2024 · 2 citations
  3. 3Risk factors for clinically relevant postoperative pancreatic fistula after pancreatectomy: a retrospective observational study2025
  4. 4Drain amylase values for clinically relevant post‐operative pancreatic fistulae2024
  5. 5Optimal Timing of Serum Lipase for Early Prediction of Clinically Relevant Pancreatic Fistula After Pancreaticoduodenectomy2026