Objective  To systematically evaluate the risk prediction model of pancreatic fistula after pancreaticoduodenectomy, and to provide a reference for clinical selection of risk assessment tools.

Methods  The relevant literature published in PubMed, Embase, the Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and SinoMed from January 1, 2016 to April 17, 2024 were searched. The PROBAST risk of bias assessment tool was used to assess the included studies, and Stata 16.0 software was used to perform Meta-analysis of common predictors included in the risk prediction model.

Results  A total of 27 studies were included. All studies reported model discrimination, 14 studies reported calibration. The area under the curve (AUC) of the receiver operator characteristic curve of the constructed model included in the study ranged from 0.620 to 0.970, the AUC of the internal validation model ranged from 0.620 to 0.915, and the AUC of the external validation model ranged from 0.744 to 0.849. The most common predictors of the included models were pancreatic texture, body mass index (BMI), pancreatic duct diameter, abdominal drainage amylase level on the 1st postoperative day, preoperative albumin level, and intraoperative bleeding loss. The risk of bias was high in all studies, and the applicability of the included studies was good.

Conclusion  The modeling quality of the risk prediction model of the pancreatic fistula after pancreaticoduodenectomy was poor, and the clinical application of the model need to be validated. In future studies, external validation and recalibration of the existing model can be considered, or a new prediction model can be constructed and verified by referring to methodological guidelines.

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