Predicting Factor for Occurrence of Postoperative Pancreatic Fistula in Patients with Pancreatic Neuroendocrine Tumors

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Abstract
Background: Neuroendocrine tumors are tumors that can develop in any organ but show a predilection for the pancreas. These can be secreting or non-secreting tumors, or they can be well differentiated or poorly differentiated, or neuroendocrine carcinomas. Surgical treatment is the only treatment with curative intent, but postoperatively, it shows an increased incidence of postoperative pancreatic fistulas. Methods: We carried out a retrospective study which included 26 patients with neuroendocrine tumors and neuroendocrine carcinomas, for whom we performed cephalic duodenopancreatectomies, distal pancreatic resections or enucleation. Results: In our study group, the incidence of pancreatic fistulas was 28%, and a series of risk factors such as the type of surgery (duodenopancreatectomy and enucleation were associated with the highest incidence of POPF), histological type (pancreatic neuroendocrine carcinomas were associated with lowest incidence of POPF), obesity (the incidence of POPF was double in the obese group), functioning tumors (with p = 0.032 and AUC = 746) and dynamic hemoglobin value (AUC = 705 shows a good predicting power, with a cutoff value = 1.8 drop hemoglobin) were indicated. Conclusions: Neuroendocrine tumors show a predisposition for the occurrence of postoperative complications, especially postoperative pancreatic fistulas. There are multiple risk factors that interact in the production of postoperative complications.

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