Dynamic platelet count value as a clinical indicator of postoperative pancreatic fistula after pancreatic resections

Introduction: Postoperative pancreatic fistula (POPF) is a common complication associated with significant morbidity and mortality.Aim: This study aimed to evaluate the dynamic change in pre-and post-operative platelet counts as a predictor of POPF.Material and methods: A retrospective study was conducted with 133 patients who underwent pancreatectomy between 1.1.2018and 31.12.2022.Data were analysed with regard to epidemiologic parameters, operations performed, POPF grading A-C, postoperative complications management, duration of hospital stay, and overall morbidity and mortality, as well as clinical outcomes and POPF-associated mortality.Ratios of postoperative platelet values (nominator) to preoperative platelet values (denominator) were assessed for postoperative days 1-9.The ratios were analysed using logistic regression models to examine their relationship with POPF, clinically significant POPF, and POPF grading.Results: Out of the 133 patients, POPF occurred in 69 (52%) patients, with clinically significant POPF in 41 (31%); POPF grade A or biochemical leak (BL) in 28 (21%); POPF grade B in 29 (22%); and POPF grade C (Reoperation or mortality) in 12 (9%).Higher platelet counts on postoperative day 1 were associated with an increased likelihood of experiencing POPF, compared to lower platelet counts (p = 0.04).No association between postoperative platelet changes and clinically significant POPF was observed.Conclusions: An increase in platelets on postoperative day 1 may serve as a clinically useful predictor for POPF.