Fístula pancreática após duodenopancreatectomia: correlação dos aspectos intra-operatórios e histologicos do pâncreas

Abstract

We conducted a retrospective study with patients that were treated with surgical resection. The rate of pancreatic fistulae was recorded. Histology classification was performed according to fibrosis and pancreatic inflammation. Results Results ResultsResults Results: We identified 77 patients, mean age was 57.6 years; 62.4% were male. As for the type of operation performed, 66.3% were gastroduodenopancreatectomies and 33.7% pancreatoduodenectomies with pylorus preservation. Regarding the number of fistulas diagnosed, it was found that 23.4% patients displayed this postoperative complication and in 66.7% the cause was cancer of the papilla. As for intraoperative macroscopic findings, we identified the classification of pancreatic texture, seen as normal in 85.8%, and the caliber of the main pancreatic duct, finding an average of 4.9 mm. There was a significant relationship between the hardened pancreatic stump and the absence of fistula. In patients with normal or soft tissue, the rate of fistula was 25.4%. Regarding ductal diameter, we identified a higher number of pancreatic anastomotic dehiscences in the absence of ductal dilation (p <0.05). We noticed that patients with an average ductal diameter of 5.4 mm (76.7%) did not show this complication. Conclusion Conclusion Conclusion Conclusion Conclusion: The presence of fibrosis and ductal dilation usually coexist and is related to a lower percentage of pancreatic fistulae.

Correlation between Preoperative Imaging and Intraoperative Risk Assessment in the Prediction of Postoperative Pancreatic Fistula Following Pancreatoduodenectomy

“…The radiologists were blinded to postoperative outcome, calculating PRV and rPDW; operating surgeons measuring the PC and iPDW were not involved in the daily postoperative care of the patients; and finally, the surgeon who did not participate in the operation evaluated the postoperative The rationales behind the present findings are twofold. First, with an increasing degree of fibrosis of the gland, its volume declines and the duct diameter increases in both relative and absolute terms [15,16]. This process corresponds well with the surgeon's assessment of the gland consistency and duct size.…”

“…The rationales behind the present findings are twofold. First, with an increasing degree of fibrosis of the gland, its volume declines and the duct diameter increases in both relative and absolute terms [15, 16]. This process corresponds well with the surgeon’s assessment of the gland consistency and duct size.…”