The following is a summary of “Predictors of post-operative pancreatic fistula formation in pancreatic neuroendocrine tumors: A national surgical quality improvement program analysis” published in the November 2022 issue of Surgery by Hedges et al.


One of the major causes of morbidity and mortality following pancreatic surgery is post-operative pancreatic fistula (POPF), which may develop in up to 34% of patients. A significant side effect of pancreas surgery is POPF. For a study, researchers sought to identify risk variables for POPF, especially in those with pancreatic neuroendocrine tumors (PNET).

For patients receiving resection for PNET, the 2014–2018 American College of Surgeons National Surgical Quality Improvement Program database was searched. It was assessed how patient, tumor, and surgical variables affected the production of POPF.

PNET resections were performed on 3,532 patients. Patients with PNET  (24.8%) had a considerably greater risk of POPF than those without PNET  (16.4%) (P < 0.0001). On multivariable analysis, the following factors were independently associated with POPF in PNET patients: male sex (OR 1.45, 95% CI 1.11-1.89), enucleation (OR 3.14, 95% CI 1.10-8.98), pancreaticoduodenectomy (OR 1.51, 95% CI 1.13-2.03), small duct size <3 mm (OR 3.24, 95% CI 1.62-6.48), and soft gland texture (OR 1.81, 95% CI 1.18–2.77).

Patients receiving resection for PNET were more likely to develop POPF, which was mostly determined by the surgical technique and gland features.

Reference: americanjournalofsurgery.com/article/S0002-9610(22)00452-4/fulltext