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

Figure 1 The patient selection flow diagram. CR-POPF: Clinically relevant postoperative pancreatic fistula; LASSO: Least absolute shrinkage and selection operator; ROC: Receiver operating characteristic; DCA: Decision curve analysis.

Figure 2 Different splenic pedicle division methods.

Figure 3 The correlation heatmap of influencing factors. BMI: Body mass index; PT: Prothrombin time. ^aP < 0.05, ^bP < 0.01, ^cP < 0.001.

Figure 4 A nomogram of pancreatic fistula based on the multivariate least absolute shrinkage and selection operator-penalized logistic regression model. ¹An independent risk factor for clinically relevant postoperative pancreatic fistula by multivariate least absolute shrinkage and selection operator-penalized logistic regression (odds ratio = 1.250; 95% confidence interval: 1.014-1.542; P = 0.037). ²An independent risk factor for clinically relevant postoperative pancreatic fistula by multivariate least absolute shrinkage and selection operator-penalized logistic regression (odds ratio = 3.578, 95% confidence interval: 1.156-11.080, P = 0.027). PT: Prothrombin time; BMI: Body mass index.

Figure 5 Receiver operating characteristic curve for the predictive nomogram of pancreatic fistula after splenectomy. ROC: Receiver operating characteristic; LASSO: Least absolute shrinkage and selection operator; AUC: Area under the receiver operating characteristic curve; CI: Confidence interval.

Figure 6 Calibration curve of the nomogram for predicting pancreatic fistula. CR-POPF: Clinically relevant postoperative pancreatic fistula.

Figure 7 Decision curve analysis of the nomogram for pancreatic fistula prediction. CR-POPF: Clinically relevant postoperative pancreatic fistula; LASSO: Least absolute shrinkage and selection operator.