Can the physiologic ability and surgical stress (E-PASS) scoring system predict operative morbidity after distal pancreatectomy?

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Purpose: Mortality rates after pancreatic resection are now lower than 5% in high-volume centers; however, morbidity remains high. This stresses the importance of identifying accurate predictors of operative morbidity after pancreatic resection. The Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system was developed for a comparative audit of general surgical patients. Our previous study confirmed its usefulness for predicting morbidity after pancreaticoduodenectomy. In the present study, we evaluated whether the E-PASS scoring system can predict the occurrence of complications after distal pancreatectomy (DP). Methods: The subjects were 46 patients who underwent DP for pancreatic disease. We studied correlations between the incidence of postoperative complications and the preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS) of the E-PASS scoring system. Results: A collective total of 20 postoperative complications developed in 13 (28.3%) of the 46 patients. All E-PASS scores, particularly PRS and CRS, were significantly higher in the patients with postoperative complications than in those without complications. The complication rate increased with increasing PRS, SSS, and CRS scores. Conclusion: The E-PASS scoring system is useful for predicting morbidity after DP.