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Clinical calculator summary

Fistula Risk Score (FRS)

The Fistula Risk Score (FRS) (Callery et al.) predicts the development of clinically relevant postoperative pancreatic fistula (CR-POPF) after a Whipple procedure.

Evidence-based context for fast calculator use

Purpose:
Fistula Risk Score predicts clinically relevant pancreatic fistula after pancreaticoduodenectomy to guide intraoperative drain placement decisions.
Population:
patients undergoing gastric or pancreatic cancer pathology, recurrence, or postoperative prognostic assessment
Factors:
Pancreas Texture, Pathology Type, Main Pancreatic Duct Diameter, Intraoperative Blood Loss
Reference:
Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM Jr. A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg. 2013;216(1):1-14.
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Fistula Risk Score (FRS)

Clinical Context & Background

The Fistula Risk Score (FRS) (Callery et al.) predicts the development of clinically relevant postoperative pancreatic fistula (CR-POPF) after a Whipple procedure. It guides intraoperative decisions (e.g. drain placement, anastomotic technique).
Primary Source EvidenceCallery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM Jr. A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg. 2013;216(1):1-14.
Formula Logic
Sum of points for Gland Texture, Pathology, Duct Diameter, and Blood Loss.

Reference Data

Risk ZoneFRS ScorePOPF Risk
Negligible Risk0~ 0%
Low Risk1 - 2~ 6-10%
Intermediate Risk3 - 6~ 20-25%
High Risk7 - 10> 35%

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use Fistula Risk Score (FRS) when fistula Risk Score predicts clinically relevant pancreatic fistula after pancreaticoduodenectomy to guide intraoperative drain placement decisions.
  • Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.

How To Interpret

  • Interpret the displayed result using the calculator-specific formula and reference table, spanning Negligible Risk through High Risk.
  • A boundary result should prompt input verification and clinical review rather than false precision.

What To Do Next

  • Confirm resection status, pathologic stage, nodal assessment, margins, histology, treatment timing, and whether the model is postoperative or preoperative.
  • Document the inputs, result, timing, and clinical context so the assessment can be reproduced.

Limitations

  • Postoperative nomograms and fistula-risk tools answer different questions and are not treatment-selection rules.
  • The result supports clinician judgment and does not independently determine treatment.

Validated Population

patients undergoing gastric or pancreatic cancer pathology, recurrence, or postoperative prognostic assessment

How to apply this result

For a representative case, verify Pancreas Texture, Pathology Type, Main Pancreatic Duct Diameter, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.

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Frequently Asked Questions

When should Fistula Risk Score (FRS) be used?

Use it for patients undergoing gastric or pancreatic cancer pathology, recurrence, or postoperative prognostic assessment when all required inputs and the intended clinical setting are confirmed.

Can Fistula Risk Score (FRS) determine treatment by itself?

No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.

Evidence-based oncology decision support. Verify with clinical guidelines.