hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2026-1-60-67hepato-1273Research ArticleПОДЖЕЛУДОЧНАЯ ЖЕЛЕЗАPANCREASПрименение шкал для прогнозирования риска развития послеоперационной панкреатической фистулыUsing scores for predicting the risk of postoperative pancreatic fistulahttps://orcid.org/0000-0003-2685-4461АтаеваА. Н.AtaevaA. N.

Атаева Аида Набиевна – аспирант кафедры факультетской хирургии № 1 Института хирургии ФГАОУ ВО «РНИМУ им. Н.И. Пирогова».

117513, Москва, ул. Островитянова, д. 1

Aida N. Ataeva – Postgraduate Student, Department of Faculty Surgery No. 1, Institute of Surgery.

1 Ostrovityanova str., Moscow, 117513

aataeva97@mail.ruhttps://orcid.org/0000-0001-5477-0084ТитковаС. М.TitkovaS. M.

Титкова Светлана Михайловна – старший научный сотрудник, отдел экспериментальной хирургии, Институт хирургии, ФГАОУ ВО «РНИМУ им. Н.И. Пирогова».

117513, Москва, ул. Островитянова, д. 1

Svetlana M. Titkova – Senior Researcher, Department of Experimental Surgery, Institute of Surgery.

1 Ostrovityanova str., Moscow, 117513

stitkova@middlebury.eduhttps://orcid.org/0000-0001-9226-8546ЛысенкоА. О.LysenkoA. O.

Лысенко Андрей Олегович – врач-онколог 2 онкологического отделения ГБУЗ «ММКЦ “Коммунарка” ДЗ г. Москвы».

108814, Москва, ул. Сосенский стан, д. 8

Andrey O. Lysenko – Oncologist, 2nd Oncology Department.

8, Sosensky Stan str., Moscow, 108814

Lysenko.a.surgery@gmail.comhttps://orcid.org/0000-0003-4081-7501КурсковА. О.KurskovA. O.

Курсков Антон Олегович – врач-онколог 2 онкологического отделения ГБУЗ «ММКЦ “Коммунарка” ДЗ г. Москвы»; старший научный сотрудник кафедры факультетской хирургии № 1 Института хирургии ФГАОУ ВО «РНИМУ им. Н.И. Пирогова».

117513, Москва, ул. Островитянова, д. 1»; 108814, Москва, ул. Сосенский стан, д. 8

Anton O. Kurskov – Oncologist, 2nd Oncology Department, Moscow Multidisciplinary Clinical Center “Kommunarka”; Senior Researcher, Department of Faculty Surgery No. 1, Institute of Surgery, Pirogov Russian NRMU.

1 Ostrovityanova str., Moscow, 117513; 8, Sosensky Stan str., Moscow, 108814

nomichi@mail.ruhttps://orcid.org/0000-0003-0153-4453КозодаеваМ. В.KozodaevaM. V.

Козодаева Маргарита Вячеславовна – канд. мед наук, врач-онколог, ГБУЗ «ММКЦ “Коммунарка” ДЗ г. Москвы».

117513, Москва, ул. Островитянова, д. 1»; 108814, Москва, ул. Сосенский стан, д. 8

Margarita V. Kozodaeva – Cand. of Sci. (Med.), Oncologist.

1 Ostrovityanova str., Moscow, 117513; 8, Sosensky Stan str., Moscow, 108814

mdkozodaeva@gmail.comhttps://orcid.org/0000-0001-5324-4752ДалгатовК. Д.DalgatovK. D.

Далгатов Камиль Далгатович – канд. мед наук, заведующий 2 онкологическим отделением ГБУЗ «ММКЦ “Коммунарка” ДЗ г. Москвы».

108814, Москва, ул. Сосенский стан, д. 8

Kamil D. Dalgatov – Cand. of Sci. (Med.), Head of the 2nd Oncology Department.

8, Sosensky Stan str., Moscow, 108814

kkd1111@mail.ruhttps://orcid.org/0000-0001-6188-6093СажинА. В.SazhinA. V.

Сажин Александр Вячеславович – доктор мед. наук, профессор, член-корреспондент РАН, заведующий кафедрой факультетской хирургии № 1 Института хирургии ФГАОУ ВО «РНИМУ им. Н.И. Пирогова».

117513, Москва, ул. Островитянова, д. 1

Alexander V. Sazhin – Doct. of Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Faculty Surgery No. 1, Institute of Surgery, Pirogov Russian NRMU.

1 Ostrovityanova str., Moscow, 117513

Sazhin-av@yandex.ruФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России (Пироговский Университет)РоссияPirogov Russian National Research Medical UniversityRussian FederationГБУЗ «Московский многопрофильный клинический центр “Коммунарка” ДЗ г. Москвы»РоссияMoscow Multidisciplinary Clinical Center “Kommunarka”Russian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России (Пироговский Университет); ГБУЗ «Московский многопрофильный клинический центр “Коммунарка” ДЗ г. Москвы»РоссияPirogov Russian National Research Medical University; Moscow Multidisciplinary Clinical Center “Kommunarka”Russian Federation2026260320263116067Copyright © Атаева А.Н., Титкова С.М., Лысенко А.О., Курсков А.О., Козодаева М.В., Далгатов К.Д., Сажин А.В., 20262026Атаева А.Н., Титкова С.М., Лысенко А.О., Курсков А.О., Козодаева М.В., Далгатов К.Д., Сажин А.В.Ataeva A.N., Titkova S.M., Lysenko A.O., Kurskov A.O., Kozodaeva M.V., Dalgatov K.D., Sazhin A.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/1273Цель

Цель. Оценка прогностической значимости и клинической эффективности дооперационных шкал оценки риска формирования панкреатической фистулы после панкреатодуоденальной резекции.

Материал и методы

Материал и методы. В исследование включили 60 пациентов со злокачественными опухолями поджелудочной железы и периампулярной зоны, перенесших панкреатодуоденальную резекцию с формированием панкреатоеюноанастомоза типа Blumgart с 2022 по 2024 год. Диагностику послеоперационной панкреатической фистулы осуществляли по критериям Международной группы по изучению хирургии поджелудочной железы (ISGPS). Для оценки прогностической точности применяли ROC-анализ и показатели диагностической эффективности.

Результаты

Результаты. У 10 пациентов (16,67 %) диагностирована послеоперационная панкреатическая фистула. При ROC-анализе отмечены сопоставимые значения площади под кривой (AUC): alternative Fistula Risk Score (a-FRS) – 0,692; updated alternative FRS (ua-FRS) – 0,636; шкала Kantor – 0,656; шкала Lapshyn – 0,649. Шкалы a-FRS и Lapshyn продемонстрировали наибольшую чувствительность (70 %), а ua-FRS – наибольшую специфичность (82 %). Положительная прогностическая ценность всех шкал оставалась низкой, с широкими доверительными интервалами.

Заключение

Заключение. Предоперационная стратификация риска формирования панкреатической фистулы с помощью шкал может быть полезным инструментом для индивидуализации хирургической тактики. Несмотря на умеренную прогностическую точность, их применение способствует повышению клинической настороженности и персонализированному подходу. Необходимы проспективные исследования на больших когортах пациентов для дальнейшего совершенствования моделей прогнозирования.

Aim

Aim. To evaluate the prognostic significance and clinical efficacy of preoperative risk scores in pancreatic fistula after pancreatic duodenal resection.

Material and methods

Material and methods. The study included 60 patients with pancreatic and periampular malignancies who underwent pancreatoduodenal resection with Blumgart pancreato-jejunal anastomosis from 2022 to 2024. Postoperative pancreatic fistulas were diagnosed according to the criteria of the International Study Group of Pancreatic Surgery (ISGPS). The ROC analysis and diagnostic efficacy indicators were used to assess the prognostic accuracy.

Results

Results. Ten patients (16.67%) were diagnosed with postoperative pancreatic fistula. The ROC analysis showed comparable areas under the curve (AUC): alternative Fistula Risk Score (a-FRS) – 0.692; updated alternative FRS (ua-FRS) – 0.636; Kantor score – 0.656; Lapshyn score – 0.649. Lapshyn and a-FRS scores demonstrated the highest sensitivity (70%); while the ua-FRS score had the highest specificity (82%). The positive prognostic value of all scores remained low, with wide confidence intervals.

Conclusion

Conclusion. Preoperative stratification of pancreatic fistula risk using scores may be a useful tool for individualizing surgical tactics. Despite moderate prognostic accuracy, their use promotes clinical alertness and a personalized approach. Prospective studies in large patient groups are needed to further improve prediction models.

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The authors declare that there are no conflicts of interest present.