Predicting pancreatic fistula post-splenectomy in cirrhosis with splenomegaly: Risk factors and nomogram validation

doi:10.4254/wjh.v18.i3.115108

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Hepatol. Mar 27, 2026; 18(3): 115108
Published online Mar 27, 2026. doi: 10.4254/wjh.v18.i3.115108

Table 2 Comparison of general data among different pancreatic fistula grades after surgery

Variables	Biochemical leak (n = 21)	Grade B (n = 4)	Grade C (n = 2)	P value
Age (years, mean ± SD)	34.19 ± 12.76	29.25 ± 20.85	41 ± 29.70	0.664
Gender (male/female)				0.648
Male	9	3	1
Female	12	1	1
Alcohol consumption				0.545
Yes	2	1	0
No	19	3	2
Smoking				0.813
Yes	9	1	1
No	12	3	1
Hypertension				0.338
Yes	7	0	1
No	14	4	1
Coronary artery disease				0.545
Yes	2	1	0
No	19	3	2
Dyslipidemia				0.752
Yes	4	1	0
No	17	3	2
Diabetes				0.542
Yes	4	1	1
No	17	4	1
BMI (kg/m²)	22.60 (21.15, 23.20)	26.90 (24.95, 28.78)	26.05 (23.80, 26.05)	0
ASA				0.677
I	14	2	1
II	5	1	1
III	2	1	0
WBC (× 10⁹/L)	2.67 (2.05, 3.94)	1.67 (1.24, 2.41)	4.04 (3.24, 4.04)	0.190
RBC (× 10¹²/L)	3.89 ± 0.59	3.33 ± 0.15	4.42 ± 0.70	0.082
HGB (g/L)	112.05 ± 19.60	98.25 ± 5.91	111 ± 15.56	0.397
PLT (× 10⁹/L)	51.00 (32.00, 55.50)	49.50 (34.00, 72.50)	41.50 (33.00, 41.50)	0.760
ALT (U/L)	24.00 (16.80, 38.00)	26.40 (19.75, 53.45)	28.50 (17.00, 28.50)	0.962
AST (U/L)	28.00 (21.00, 35.50)	31.00 (19.25, 49.50)	23.00 (16.00, 23.00)	0.570
TB (μmol/L)	16.20 (13.05, 31.17)	11.60 (7.03, 15.25)	18.70 (17.00, 18.70)	0.392
ALB (g/L)	38.90 (33.85, 40.75)	31.95 (29.15, 37.68)	41.45 (38.80, 41.45)	0.259
PT (seconds)	13.30 (12.00, 13.75)	11.80 (10.48, 12.60)	11.55 (11.20, 11.55)	0.155
INR	1.16 (1.05, 1.26)	1.14 (0.98, 1.21)	1.06 (1.04, 1.06)	0.423
APTT (seconds)	35.20 (31.80, 37.80)	30.05 (26.78, 33.40)	30.60 (29.00, 30.60)	0.061
D-Dimer (mg/L FEU)	0.23 (0.19, 0.56)	0.24 (0.19, 0.79)	0.38 (0.32, 0.38)	0.872
Child-Pugh classification				0.752
A	17	3	2
B	4	1	0
C		0	0
Ascite				0.227
No ascites	17	2	1
Mild ascites	2	1	1
Moderate to severe ascites	2	1	0
Splenic length (mm)	188.62 ± 19.74	207 ± 5.72	195.5 ± 0.71	0.192
Splenic thickness (mm)	67.71 ± 11.89	76 ± 2.94	75 ± 18.38	0.344
Portal vein diameter (mm)	15.00 (13.00, 16.00)	14.00 (13.25, 14.75)	15.00 (13.00, 15.00)	0.773
Splenic vein diameter (mm)	15.00 (14.00, 16.00)	15.00 (15.00, 16.50)	15.50 (15.00, 15.50)	0.828
Main pancreatic duct diameter (mm)	2.80 (2.05, 3.05)	2.25 (1.93, 3.70)	3.25 (1.70, 3.25)	0.742
Pancreatic CT value (HU)	32.00 (27.50, 35.00)	32.50 (28.75, 37.75)	41.00 (34.00, 41.00)	0.093
Surgical method				0.162
Splenectomy	20	4	1
Devascularization	1	0	1
Splenic pedicle vessel division method				0.733
First-order splenic pedicle vessel division	16	3	2
Second-order splenic pedicle vessel division	5	1	0
Stapler division				0.497
Yes	12	3	2
No	9	1	0
Pancreatic texture				0.008
Soft	16	3	0
Firm	5	1	0
Hard	0	0	2
Drainage fluid amylase	1485.00 (1294.50, 1961.00)	12197.50 (10377.75, 24509.75)	54671.50 (30000.00, 54671.50)	0
Hospital stay (days)	14.00 (12.00, 16.50)	22.50 (11.25, 33.75)	14.00 (14.00, 14.00)	0.079
Blood loss (mL)	340.00 (300.00, 372.50)	380.00 (230.00, 447.50)	400.00 (350.00, 400.00)	0.460

BMI: Body mass index; ASA: Acetylsalicylic acid; WBC: White blood cell; RBC: Red blood cell; HGB: Hemoglobin; PCT: Plateletcrit; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TB: Total bilirubin; ALB: Albumin; PT: Prothrombin time; APTT: Activated partial thromboplastin time; INR: International normalized ratio; FEU: Fibrinogen equivalent unit; CT: Computed tomography; HU: Hounsfield unit.

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Citation: Huang L, Li QL, Yu QS, Peng H, Zhen Z, Zhang Q, Shen Y. Predicting pancreatic fistula post-splenectomy in cirrhosis with splenomegaly: Risk factors and nomogram validation. World J Hepatol 2026; 18(3): 115108
URL: https://www.wjgnet.com/1948-5182/full/v18/i3/115108.htm
DOI: https://dx.doi.org/10.4254/wjh.v18.i3.115108

Huang L, Li QL, Yu QS, Peng H, Zhen Z, Zhang Q, Shen Y. Predicting pancreatic fistula post-splenectomy in cirrhosis with splenomegaly: Risk factors and nomogram validation. World J Hepatol 2026; 18(3): 115108 [DOI: 10.4254/wjh.v18.i3.115108]

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