Predicting post‐operative pancreatic fistulae using preoperative pancreatic imaging: a systematic review

Barreto, Savio George; Dirkzwager, Ilse; Windsor, John A.; Pandanaboyana, Sanjay

doi:10.1111/ans.14891

Cited by 12 publications

(5 citation statements)

References 39 publications

(89 reference statements)

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“…To the best of our knowledge, PD is currently the main treatment for pancreatic cancer. Although surgical techniques and postoperative management have improved in recent years, with the mortality rate decreasing to approximately 5% in large-capacity hospitals compared to the previous period ( 25 ), the incidence of postoperative complications is still as high as 26.7% ( 26 ). However, the goal of clinicians is to find predictors of POPF so that high-risk patients can be identified before surgery to avoid the onset of POPF.…”

Section: Discussionmentioning

confidence: 99%

Impact of Fatty Pancreas on Postoperative Pancreatic Fistulae: A Meta-Analysis

et al. 2021

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BackgroundSoft pancreas is widely recognized as an important risk factor for the development of postoperative pancreatic fistula (POPF). Although fatty pancreas (FP) has not been formally defined as a cause of pancreatic fistula, existing research has shown that it can increase the incidence of POPF by increasing pancreatic tenderness; therefore, it may be a potential risk factor. This study aimed to discern whether FP was associated with POPF.MethodTwo reviewers independently performed literature searches from five electronic databases. According to the established inclusion criteria, we extracted necessary data from the studies that met the criteria for further analysis. We pooled the odds ratios (ORs) from individual studies using a random-effects model to investigate the associations between POPF and the prognosis of FP.ResultA total of 11 studies involving 2484 individuals were included. The pooled prevalence of POPF was 18% (95% CI: 12-24%). Body mass index (BMI) was associated with a significantly increased risk of POPF (OR=3.55; 95% CI: 1.83, 6.86; P=0.0002; I²=0). FP was obviously associated with the occurrence of POPF (OR=3.75; 95% CI: 1.64, 8.58; P=0.002; I²=78).ConclusionFP is closely associated with the development of POPF, and the early identification of these high-risk patients can help to reduce the incidence of POPF.Systematic Review RegistrationThe Registration URL link is (https://www.crd.york.ac.uk/PROSPERO/). The ID is “CRD42021265141”.

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Section: Discussionmentioning

confidence: 99%

Impact of Fatty Pancreas on Postoperative Pancreatic Fistulae: A Meta-Analysis

et al. 2021

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“…Add-on EUS modules such as real-time elastography (RTE) have provided semiquantitative or quantitative information in several pancreatic diseases [52] and expectations were made for pancreatic steatosis too. However, RTE during EUS as a measure of pancreatic elasticity has proven to be correlated with pancreatic fibrosis, but not with fatty infiltration staged by histology [53][54].…”

Section: Endoscopic Ultrasoundmentioning

confidence: 99%

Non-alcoholic fatty pancreas disease – practices for clinicians

Pinte

Balaban

Băicuș

et al. 2019

Romanian Journal of Internal Medicine

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Obesity is a growing health burden worldwide, increasing the risk for several diseases featuring the metabolic syndrome – type 2 diabetes mellitus, dyslipidemia, non-alcoholic fatty liver disease and cardiovascular diseases. With the increasing epidemic of obesity, a new pathologic condition has emerged as a component of the metabolic syndrome – that of non-alcoholic fatty pancreas disease (NAFPD). Similar to non-alcoholic fatty liver disease (NAFLD), NAFPD comprises a wide spectrum of disease – from deposition of fat in the pancreas – fatty pancreas, to pancreatic inflammation and possibly pancreatic fibrosis. In contrast with NAFLD, diagnostic evaluation of NAFPD is less standardized, consisting mostly in imaging methods. Also the natural evolution of NAFPD and its association with pancreatic cancer is much less studied. Not least, the clinical consequences of NAFPD remain largely presumptions and knowledge about its metabolic impact is limited. This review will cover epidemiology, pathogenesis, diagnostic evaluation tools and treatment options for NAFPD, with focus on practices for clinicians.

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“…Given the real difficulty in obtaining a preoperative differential diagnosis (PDAC/DC), this study aims to assess the diagnostic value of these parameters and obtain a preoperative diagnostic score. This paper analyzed many clinical, biological, and radiological parameters, yet present in literature, that are usually subject of study for pancreatic head neoplasm in order to evaluate preoperative patients' operability, neoplasm's resectability, and risk of postoperative complications [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Pancreatic ductal adenocarcinoma and distal cholangiocarcinoma: a proposal of preoperative diagnostic score for differential diagnosis

et al. 2021

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Purpose The differential diagnosis between primary adenocarcinoma of the pancreas head and distal cholangiocarcinoma remains a clinical challenge. Recent studies have shown important differences in terms of survival between these tumors. Therefore, different treatments should be considered, but the preoperative histological diagnosis is still difficult. Aim of this study is to create a preoperative diagnostic score for differential diagnosis between primary pancreatic adenocarcinoma and primary distal cholangiocarcinoma. Methods One hundred eighty consecutive patients who underwent pancreaticoduodenectomy at Sapienza University of Rome from January 2010 to December 2019 were retrospectively analyzed. Inclusion criteria were pancreatic or biliary histologic origin obtained by definitive postoperative histological examination. Exclusion criteria were diagnosis of ampullary carcinoma, non-ampullary duodenal adenocarcinoma, pancreatic metastasis, and benign disease. One hundred one patients were considered eligible for the retrospective study. Preoperative biological, clinical, and radiological parameters were considered. Results CRP > 10 mg/dL (p = 0.001), modified Glasgow Prognostic Score 2 (p = 0.002), albumin < 35 g/L (p = 0.05), CA 19-9 > 230 U/mL (p = 0.001), and Wirsung diameter > 3 mm (p < 0.001) were significant at univariate logistic analysis. Multivariate logistic analysis has shown that parameters independently associated with primary pancreatic adenocarcinoma were CRP > 10 mg/dL (p = 0.012), CA 19-9 > 230 U/mL (p = 0.043), and diameter of the Wirsung > 3 mm (p = 0.005). Through these parameters, a diagnostic score has been developed to predict a primary pancreatic adenocarcinoma when > 1 and a primary distal cholangiocarcinoma when < 1. Conclusion This feasible and low-cost diagnostic score could have a potential impact to differentiate pancreatic cancer histologic origin and to improve target therapeutic strategy.

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Predicting post‐operative pancreatic fistulae using preoperative pancreatic imaging: a systematic review

Cited by 12 publications

References 39 publications

Impact of Fatty Pancreas on Postoperative Pancreatic Fistulae: A Meta-Analysis

Impact of Fatty Pancreas on Postoperative Pancreatic Fistulae: A Meta-Analysis

Non-alcoholic fatty pancreas disease – practices for clinicians

Pancreatic ductal adenocarcinoma and distal cholangiocarcinoma: a proposal of preoperative diagnostic score for differential diagnosis

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