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Fistula Risk Score after pancreatoduodenectomy

Fistula Risk Score

Sum the Callery 2013 Fistula Risk Score from caller-assigned gland texture, pathology, pancreatic duct diameter, and estimated blood loss, and return the published 0–10 total and fistula band.

LIVE $0.005 USDC GET /api/calc/fistula_risk

Markdown: /docs/fistula-risk.md · Canonical: https://magentlab.com/docs/fistula-risk

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Sum the Callery 2013 Fistula Risk Score from caller-assigned gland texture, pathology, pancreatic duct diameter, and estimated blood loss, and return the published 0–10 total and fistula band.

When to use

When an agent has already assigned Callery 2013 intraoperative inputs after pancreatoduodenectomy and needs the published integer FRS total and band, not a CR-POPF diagnosis, ISGPS grade, Ranson, or BISAP score.

When not to use

Not a medical device. magent does not palpate the gland or measure EBL. Gland texture, pathology, duct diameter, and EBL are caller-assigned intraoperative values.
Intraoperative assignment: Callery 2013 is scored at pancreatoduodenectomy, not from a preoperative chart.
Does not grade CR-POPF and is not an ISGPS grade. The score is a published risk total, not a fistula diagnosis.
Not Ranson and not BISAP. This tool is the Callery 2013 Fistula Risk Score only.

Formula

FRS = gland_texture (firm 0, soft 2) + pathology (pdac_or_pancreatitis 0, other 1) + duct_mm (>=5 0, >=4 1, >=3 2, >=2 3, else 4) + ebl_ml (<=400 0, <=700 1, <=1000 2, else 3); Callery 2013; max 10; negligible 0, low 1-2, intermediate 3-6, high 7-10

Citation

Title: A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy.
Authors: Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM
Source: J Am Coll Surg. 2013;216(1):1-14
DOI: 10.1016/j.jamcollsurg.2012.09.002

Worked example

Firm PDAC, 5 mm duct, EBL 300 mL

Given: duct_mm=5ebl_ml=300gland_texture=firmpathology=pdac_or_pancreatitis

firm → 0; pdac_or_pancreatitis → 0; duct 5 mm → 0; EBL 300 → 0
Score = 0 (max 10); fistula_band negligible

Soft other pathology, 1 mm duct, EBL 1100 mL

Given: duct_mm=1ebl_ml=1100gland_texture=softpathology=other

soft → 2; other → 1; duct 1 mm → 4; EBL 1100 → 3
Score = 10 (max 10); fistula_band high

Also searched as

Fistula Risk Score
Callery FRS
pancreatic fistula risk
CR-POPF risk score
Callery 2013 score
pancreatoduodenectomy fistula
soft pancreas fistula score

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/fistula_risk?gland_texture=firm&pathology=pdac_or_pancreatitis&duct_mm=5&ebl_ml=300

Full URL: https://api.magentlab.com/api/calc/fistula_risk?gland_texture=firm&pathology=pdac_or_pancreatitis&duct_mm=5&ebl_ml=300

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/fistula_risk?gland_texture=firm&pathology=pdac_or_pancreatitis&duct_mm=5&ebl_ml=300"

Parameters

Name	Type	Required	Description
`gland_texture`	string	required · firm, soft	Caller-assigned pancreatic gland texture at pancreatoduodenectomy (Callery 2013). firm or soft. firm scores 0; soft scores 2. magent does not palpate the gland.
`pathology`	string	required · pdac_or_pancreatitis, other	Caller-assigned pathology (Callery 2013). pdac_or_pancreatitis (pancreatic ductal adenocarcinoma or pancreatitis) scores 0. other (ampullary, duodenal, cystic, or islet cell) scores 1.
`duct_mm`	number	required	Caller-assigned pancreatic duct diameter in mm, number 0.5–20 (Callery 2013 integer-mm table). ≥5 scores 0; ≥4 scores 1; ≥3 scores 2; ≥2 scores 3; else 4 (so 4.0–4.999 scores 1; 1.5 and ≤1 score 4). magent does not measure the duct.
`ebl_ml`	number	required	Caller-assigned estimated blood loss in mL, number 0–10000 (Callery 2013). ≤400 scores 0; 401–700 scores 1; 701–1000 scores 2; >1000 scores 3. magent does not measure EBL.

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/fistula_risk Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "duct_mm": "5",
      "ebl_ml": "300",
      "gland_texture": "firm",
      "pathology": "pdac_or_pancreatitis"
    },
    {
      "duct_mm": "5",
      "ebl_ml": "300",
      "gland_texture": "firm",
      "pathology": "pdac_or_pancreatitis"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/fistula_risk",
  "items": [
    {
      "components": [
        {
          "value": "firm",
          "factor": "gland_texture",
          "points": 0,
          "present": true
        },
        {
          "value": "pdac_or_pancreatitis",
          "factor": "pathology",
          "points": 0,
          "present": true
        },
        {
          "value": 5.0,
          "factor": "duct_mm",
          "points": 0,
          "present": true
        },
        {
          "value": 300.0,
          "factor": "ebl_ml",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM",
        "doi": "10.1016/j.jamcollsurg.2012.09.002",
        "id": "callery-2013",
        "pmid": "23122535",
        "source": "J Am Coll Surg. 2013;216(1):1-14",
        "title": "A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy."
      },
      "formula": "fistula_risk",
      "formula_expression": "FRS = gland_texture (firm 0, soft 2) + pathology (pdac_or_pancreatitis 0, other 1) + duct_mm (>=5 0, >=4 1, >=3 2, >=2 3, else 4) + ebl_ml (<=400 0, <=700 1, <=1000 2, else 3); Callery 2013; max 10; negligible 0, low 1-2, intermediate 3-6, high 7-10",
      "max_score": 10,
      "score": 0,
      "duct_mm": 5.0,
      "ebl_ml": 300.0,
      "fistula_band": "negligible",
      "gland_texture": "firm",
      "pathology": "pdac_or_pancreatitis"
    },
    {
      "components": [
        {
          "value": "firm",
          "factor": "gland_texture",
          "points": 0,
          "present": true
        },
        {
          "value": "pdac_or_pancreatitis",
          "factor": "pathology",
          "points": 0,
          "present": true
        },
        {
          "value": 5.0,
          "factor": "duct_mm",
          "points": 0,
          "present": true
        },
        {
          "value": 300.0,
          "factor": "ebl_ml",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM",
        "doi": "10.1016/j.jamcollsurg.2012.09.002",
        "id": "callery-2013",
        "pmid": "23122535",
        "source": "J Am Coll Surg. 2013;216(1):1-14",
        "title": "A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy."
      },
      "formula": "fistula_risk",
      "formula_expression": "FRS = gland_texture (firm 0, soft 2) + pathology (pdac_or_pancreatitis 0, other 1) + duct_mm (>=5 0, >=4 1, >=3 2, >=2 3, else 4) + ebl_ml (<=400 0, <=700 1, <=1000 2, else 3); Callery 2013; max 10; negligible 0, low 1-2, intermediate 3-6, high 7-10",
      "max_score": 10,
      "score": 0,
      "duct_mm": 5.0,
      "ebl_ml": 300.0,
      "fistula_band": "negligible",
      "gland_texture": "firm",
      "pathology": "pdac_or_pancreatitis"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	fistula_risk
`formula_expression`	string	Exact expression used
`score`	integer	Callery 2013 Fistula Risk Score 0-10
`max_score`	integer	10
`fistula_band`	string	Callery 2013 band: negligible (0), low (1-2), intermediate (3-6), or high (7-10). Not a CR-POPF diagnosis and not an ISGPS grade.
`gland_texture`	string	Caller-assigned gland texture used (firm or soft)
`pathology`	string	Caller-assigned pathology used (pdac_or_pancreatitis or other)
`duct_mm`	number	Pancreatic duct diameter in mm used
`ebl_ml`	number	Estimated blood loss in mL used
`components`	array	Per-factor Callery 2013 points
`citation`	object	Callery et al. J Am Coll Surg 2013 citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "value": "firm",
      "factor": "gland_texture",
      "points": 0,
      "present": true
    },
    {
      "value": "pdac_or_pancreatitis",
      "factor": "pathology",
      "points": 0,
      "present": true
    },
    {
      "value": 5.0,
      "factor": "duct_mm",
      "points": 0,
      "present": true
    },
    {
      "value": 300.0,
      "factor": "ebl_ml",
      "points": 0,
      "present": true
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM",
    "doi": "10.1016/j.jamcollsurg.2012.09.002",
    "id": "callery-2013",
    "pmid": "23122535",
    "source": "J Am Coll Surg. 2013;216(1):1-14",
    "title": "A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy."
  },
  "formula": "fistula_risk",
  "formula_expression": "FRS = gland_texture (firm 0, soft 2) + pathology (pdac_or_pancreatitis 0, other 1) + duct_mm (>=5 0, >=4 1, >=3 2, >=2 3, else 4) + ebl_ml (<=400 0, <=700 1, <=1000 2, else 3); Callery 2013; max 10; negligible 0, low 1-2, intermediate 3-6, high 7-10",
  "max_score": 10,
  "score": 0,
  "duct_mm": 5.0,
  "ebl_ml": 300.0,
  "fistula_band": "negligible",
  "gland_texture": "firm",
  "pathology": "pdac_or_pancreatitis"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_fistula_risk`	gland_texture must be firm or soft, pathology pdac_or_pancreatitis or other, duct_mm a number 0.5-20, and ebl_ml a number 0-10000 (Callery 2013 Fistula Risk Score). Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

Ranson — Sum the eleven Ranson 1974 prognostic signs (five at admission, six during the first 48 hours) and return the published mortality band.
BISAP — Compute the Wu 2008 BISAP score for early prediction of mortality in acute pancreatitis from BUN, caller-assigned impaired mental status, caller-assigned SIRS, age, and caller-assigned pleural effusion.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
Execution is timeout-bounded and concurrency-capped.
Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.