Association Between the Incidence of Pancreatic Fistula After Pancreaticoduodenectomy and the Degree of Pancreatic Fibrosis

Deng, Yong; Zhao, Baixiong; Yang, Mingzhi; Li, Chuan-hong; Zhang, Leida

doi:10.1007/s11605-017-3660-2

Cited by 34 publications

(45 citation statements)

References 18 publications

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“…The pancreatic duct size has been reported as an independent risk factor for POPF . It could be measured at the presumed surgical pancreatic margin or by preoperative CT scan.…”

Section: Discussionmentioning

confidence: 99%

“…Deng et al suggested that the degree of pancreatic fibrosis is a prognostic factor which influences the pancreatic texture and the incidence of POPF. 16 The pancreatic CT value was used as a quantitative index for calculating the pancreatic fibrosis score to predict the incidence of POPF. Mathur et al revealed that patients with POPF presented decreased pancreatic fibrosis score (<2%).…”

Section: Discussionmentioning

confidence: 99%

“…The pancreatic duct size has been reported as an independent risk factor for POPF. 16,18,56,57 It could be measured at the presumed surgical pancreatic margin or by preoperative CT scan. In our study, the pancreatic duct size was intraoperatively evaluated by the pancreatic surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…The softness or hardness of pancreatic texture is decided by the composition of pancreatic parenchyma, which is determined by the fibrous and fatty tissue. Thus, the assessment of pancreatic fibrosis has been elaborated to assess the visualization of pancreatic leakage . In this study, we elucidated that the preoperative concentration of HYAL‐1 in serum, pancreatic fibrosis score, and pancreatic duct size were independent factors for enabling the risk of POPF in patients who underwent PD.…”

Section: Introductionmentioning

confidence: 91%

“…Thus, the assessment of pancreatic fibrosis has been elaborated to assess the visualization of pancreatic leakage. [16][17][18] In this study, we elucidated that the preoperative concentration of HYAL-1 in serum, pancreatic fibrosis score, and pancreatic duct size were independent factors for enabling the risk of POPF in patients who underwent PD. To investigate the main mechanisms of HYAL-1 on PF, the genomic bioinformatics analysis was assessed for 7944 genes which were correlated with HYAL-1 in pancreatic ductal adenocarcinoma (PDAC) tissues from The Cancer Genome Atlas (TCGA) and the detailed effects of them were estimated.…”

Section: Introductionmentioning

confidence: 91%

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HYAL‐1‐induced autophagy facilitates pancreatic fistula for patients who underwent pancreaticoduodenectomy

Fengyu

Yuan

et al. 2019

FASEB j.

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The main mechanism of hyaluronidase 1(HYAL-1) in the development of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD) was unknown. In this study, a comprehensive inventory of pre-, intra-, and postoperative clinical and biological data of two cohorts (62 pancreatic cancer [PCa] and 111 pancreatic ductal adenocarcinoma [PDAC]) which could induce POPF were retrospectively analyzed.Then, a total of 7644 genes correlated with HYAL-1 was predicted in PDAC tissues and the enriched pathway, kinase targets and biological process of those correlated genes were evaluated. Finally, a mouse pancreatic fistula (PF) model was first built and in vitro studies were performed to investigate the effects of HYAL-1 on PF progression. Our data indicated that preoperative serum HYAL-1 level, pancreatic fibrosis score, and pancreatic duct size were valuable factors for detecting POPF of Grade B and C. The serum HYAL-1 level of 2.07 mg/ml and pancreatic fibrosis score of 2.5 were proposed as the cutoff values for indicating POPF. The bioinformatic analysis and in vitro and in vivo studies demonstrated that HYAL-1 facilitates pancreatic acinar cell autophagy via the dephosphorylation of adenosine 5'-monophosphate-activated protein kinase (AMPK) and signal transducers and activators of transcription 3 (STAT3) signaling pathways, which exacerbate pancreatic secretion and inflammation. In summary, the preoperative serum HYAL-1 was a significant predictor for POPF in patients who underwent PD. Tumor-induced HYAL-1 is one of core risk in accelerating PF and then promoting pancreatic secretion and acute inflammation response through the AMPK and STAT3-induced autophagy. K E Y W O R D Sautophagy, fibrosis, HYAL-1, pancreaticoduodenectomy, pancreatic fistula | 2525 LI et aL.

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“…The pancreatic duct size has been reported as an independent risk factor for POPF . It could be measured at the presumed surgical pancreatic margin or by preoperative CT scan.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 91%

See 3 more Smart Citations

HYAL‐1‐induced autophagy facilitates pancreatic fistula for patients who underwent pancreaticoduodenectomy

Fengyu

Yuan

et al. 2019

FASEB j.

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Evaluation of Pancreatic Fibrosis Grading by Multiparametric Quantitative Magnetic Resonance Imaging

Liu

Shi

Lan

et al. 2021

Magnetic Resonance Imaging

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Background: Early detection and grading of pancreatic fibrosis (PF) are important and challenging clinical goals. Purpose: To determine main pancreatic duct (MPD) diameter, pancreatic thickness, and grades of PF via magnetic resonance elastography (MRE), T1 mapping, and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), assessing respective diagnostic performances. Study Type: Prospective. Subjects: Histopathologic and imaging records (MRE, T1 mapping, and IVIM-DWI) generated by 144 patients between December 2018 and May 2020 were collected for analysis. Grades of PF were distributed as follows:

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Drain Lipase Levels and Decreased Rate of Drain Amylase Levels as Independent Predictors of Pancreatic Fistula with Nomogram After Pancreaticoduodenectomy

et al. 2021

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Background Pancreaticoduodenectomy (PD) has recently been improved due to its increased safety. However, postoperative pancreatic fistula (POPF) remains a lethal complication of PD. Identifying novel clinicophysiological risk factors for POPF during the early post‐PD period would help improve patient morbidity and mortality. Therefore, this retrospective study aimed to evaluate possible risk factors during the early postoperative period after pancreaticoduodenectomy (PD). Methods Data from 349 patients who underwent PD between 2007 and 2012 were examined retrospectively. All patients were classified into 2 groups: group A, patients without fistulae or biochemical leaks (288 patients), and group B, those with grade B or C POPF (61 patients). Data on various clinicophysiological parameters, including serum and drain laboratory data, were collected. Univariate and multivariate analyses were performed to evaluate POPF predictors. A predictive nomogram was established for these results. Results Univariate analysis showed that various serum and drain‐related factors, such as white blood cell count, C‐reactive protein levels, drain amylase (DAMY) levels, and drain lipase (DLIP) levels, were possible POPF risk factors. Multivariate analysis confirmed that postoperative day (POD) 1 DLIP levels (hazard ratio, 15.393; p = 0.037) and decreased rate (POD3/1) of DAMY levels (hazard ratio, 4.415; p = 0.028) were independent risk factors. Further, POD1 DLIP levels and decreased rate of DAMY levels were significantly lower in group A than in group B. The accuracy of nomogram was 0.810. Conclusions POD1 DLIP levels (> 245 U/mL) and decreased rate of DAMY levels (> 0.44) were POPF risk factors, making them possible biomarkers for POPF.

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Association Between the Incidence of Pancreatic Fistula After Pancreaticoduodenectomy and the Degree of Pancreatic Fibrosis

Cited by 34 publications

References 18 publications

HYAL‐1‐induced autophagy facilitates pancreatic fistula for patients who underwent pancreaticoduodenectomy

HYAL‐1‐induced autophagy facilitates pancreatic fistula for patients who underwent pancreaticoduodenectomy

Evaluation of Pancreatic Fibrosis Grading by Multiparametric Quantitative Magnetic Resonance Imaging

Drain Lipase Levels and Decreased Rate of Drain Amylase Levels as Independent Predictors of Pancreatic Fistula with Nomogram After Pancreaticoduodenectomy

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