Gastroenterology Review
eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
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1/2026
vol. 21
 
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abstract:
Original paper

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

Maria Papadoliopoulou
1
,
Francesk Mulita
2
,
Ioannis Margaris
1
,
Mirto Moutafi
3
,
Dimitrios Vouros
4
,
Theodoros Sidiropoulos
1
,
Panagiotis Kokoropoulos
1
,
Konstantinos Toutouzas
4
,
Nikolaos V. Michalopoulos
4
,
Nikolaos Arkadopoulos
1

  1. 4th Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
  2. Department of Surgery, General University Hospital of Patras, Greece
  3. Section of Medical Oncology, 2nd Department of Internal Medicine, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
  4. 1st Propaedeutic Department of Surgery, Hippocration General Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
Gastroenterology Rev 2026; 21 (1): 97–102
DOI: https://doi.org/10.5114/pg.2026.160542
Online publish date: 2026/03/27
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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 1.1.2018 and 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.

keywords:

platelets, postoperative pancreatic fistula (POPF), POPF grading, pancreatic resections



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