KUMJ | VOL. 21 | NO. 2 | ISSUE 82 | APRIL - JUNE, 2023
Prediction of Postoperative Major Complications in Pancreaticoduodenectomy -a Prospective Comparative Analysis of Braga and WHipple-ABACUS Scores
Sah DN, Lakhey PJ, Bhandari RS
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
χ
2
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 WHippleABACUS
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.
Keyword : Braga score, Pancreaticoduodenectomy, Post-operative pancreatic fistula, WHippleABACUS score
