Pancreatic fistulas following distal pancreatectomy are unrelated to the texture quality of the pancreas

Eshmuminov, Dilmurodjon; Karpovich, I P; Kapp, Joshua; Töpfer, Antonia; Endhardt, Katharina; Oberkofler, Christian E.; Petrowsky, Henrik; Lenggenhager, Daniela; Tschuor, Christoph; Clavien, Pierre‐Alain

doi:10.1007/s00423-020-02071-y

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…Objective histopathologic analysis of pancreatic parenchyma showed no histological features were predictive of POPF, including steatosis (p = 0.75) and fibrosis (p = 0.571). 69 Hence, the result argues against the importance of pancreatic texture, specifically fibrosis, in linking diabetes to CR-POPF. The association between diabetes and CR-POPF particularly after DP remains unexplained.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of risk factors of postoperative pancreatic fistula after distal pancreatectomy in the era of 2016 International Study Group pancreatic fistula definition

Chong

Ratnayake

Lee

et al. 2021

HPB

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Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of risk factors of postoperative pancreatic fistula after distal pancreatectomy in the era of 2016 International Study Group pancreatic fistula definition

Chong

Ratnayake

Lee

et al. 2021

HPB

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“…A softer pancreas is often characterized by more acinar cells in the resection surface with stronger exocrine function, which may contribute to POPF 18,19 . However, pancreatic texture was a subjective factor determined by surgeon intraoperatively and lack objective accuracy, 20 resulting in its controversial role in the prediction of POPF in current and previous studies 3,21 . A higher BMI was an indicator of a softer pancreas and higher pancreatic thickness, which is highly related with visceral obesity and sarcopenia.…”

Section: Resultsmentioning

confidence: 89%

Comparing the distal pancreatectomy fistula risk score (D‐FRS) and DISPAIR‐FRS for predicting pancreatic fistula after distal pancreatectomy

Tang,

Wang,

et al. 2023

ANZ Journal of Surgery

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BackgroundsDistal pancreatectomy fistula risk score (D‐FRS) and DISPAIR‐FRS has not been widely validated for predicting postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP).MethodsWe retrospectively analysed 104 patients undergoing DP. The predictive value of the D‐FRS and DISPAIR‐FRS were compared. Risk factors associated with POPF were investigated by multivariate analysis.ResultsOf the 104 patients, 23 (22.1%) were categorized into the POPF group (all grade B). The areas under the ROC (AUCs) of the D‐FRS (preoperative), D‐FRS (intraoperative), and DISPAIR‐FRS were 0.737, 0.809, and 0.688, respectively. Stratified by the D‐FRS (preoperative), the POPF rates in low‐risk, intermediate‐risk, and high‐risk groups were 5%, 22.6%, and 36.4%, respectively. By the D‐FRS (intraoperative), the POPF rates in low‐risk, intermediate‐risk, and high‐risk groups were 8.8%, 47.1%, and 47.4%, respectively. By the DISPAIR‐FRS, the POPF rates in low‐risk, intermediate‐risk, and extreme‐high‐risk groups were 14.8%, 23.8% and 62.5%, respectively. Body mass index and main pancreatic duct diameter were independent risk factors of POPF both in preoperative (P = 0.014 and P = 0.033, respectively) and intraoperative (P = 0.015 and P = 0.039) multivariate analyses.ConclusionBoth the D‐FRS (preoperative), D‐FRS (intraoperative), and DISPAIR‐FRS has good performance in POPF prediction after DP. The risk stratification was not satisfactory in current Asian cohort.

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“…A softer pancreas is often characterized by more acinar cells in the resection surface with stronger exocrine function, which may contribute to POPF(18, 19). However, pancreatic texture was a subjective factor determined by surgeon intraoperatively and lack objective accuracy (20), resulting in its controversial role in the prediction of POPF in current and previous studies (3,21). The surgeon's evaluated of texture was therefore not considered as a good parameter for the establishment of POPF predictive model The objective and quantitative texture evaluation methods, such as the measurement of pancreatic density and enhancement pattern by CT or magnetic resonance (MR) imaging, may help in the future (22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

External validation and comparison of distal pancreatectomy fistula risk score (D-FRS) and DISPAIR-FRS for predicting pancreatic fistula after distal pancreatectomy

Tang

Wang

Jian

et al. 2023

Preprint

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Background Distal pancreatectomy fistula risk score (D-FRS) and DISPAIR-FRS has not been widely validated for predicting postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP).Methods We retrospectively analyzed 104 patients undergoing DP. The predictive value of the D-FRS and DISPAIR were compared. Risk factors associated with POPF were investigated by multivariate analysis.Results Of the 104 patients, 23 (22.1%) were categorized into the POPF group (all grade B). The areas under the ROC (AUCs) of the D-FRS (preoperative), D-FRS (intraoperative), and DISPAIR-FRS were 0.737, 0.809, and 0.688, respectively. Stratified by the D-FRS (preoperative), the POPF rates in low-risk, intermediate-risk, and high-risk groups were 5%, 22.6%, and 36.4%, respectively. By the D-FRS (intraoperative), the POPF rates in low-risk, intermediate-risk, and high-risk groups were 8.8%, 47.1%, and 47.4%, respectively. By the DISPAIR-FRS, the POPF rates in low-risk, intermediate-risk, and extreme-high-risk groups were 14.8%, 23.8% and 62.5%, respectively. Body mass index and main pancreatic duct diameter were independent risk factors of POPF both in preoperative (P = 0.014 and P = 0.033, respectively) and intraoperative (P = 0.015 and P = 0.039) multivariate analyses.Conclusions Both the D-FRS (preoperative), D-FRS (intraoperative), and DISPAIR-FRS has good performance in POPF prediction after DP. The risk stratification was not satisfactory in current Asian cohort.

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Pancreatic fistulas following distal pancreatectomy are unrelated to the texture quality of the pancreas

Cited by 7 publications

References 19 publications

Systematic review and meta-analysis of risk factors of postoperative pancreatic fistula after distal pancreatectomy in the era of 2016 International Study Group pancreatic fistula definition

Systematic review and meta-analysis of risk factors of postoperative pancreatic fistula after distal pancreatectomy in the era of 2016 International Study Group pancreatic fistula definition

Comparing the distal pancreatectomy fistula risk score (D‐FRS) and DISPAIR‐FRS for predicting pancreatic fistula after distal pancreatectomy

External validation and comparison of distal pancreatectomy fistula risk score (D-FRS) and DISPAIR-FRS for predicting pancreatic fistula after distal pancreatectomy

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