Preoperative computed tomography scan to predict pancreatic fistula after distal pancreatectomy using gland and tumor characteristics

Jutric, Zeljka; Johnston, William; Grendar, Jan; Haykin, Leah A.; Mathews, Connor; Harmon, Liv; Shen, Jian; Hahn, Hejin P.; Coy, David; Cassera, Maria A.; Helton, W. Scott; Rocha, Flavio G.; Wolf, Ronald; Hansen, Paul; Hammill, Chet W.; Newell, Pippa

doi:10.1016/j.amjsurg.2016.02.001

Cited by 14 publications

(11 citation statements)

References 26 publications

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“…13,16,19,20 However, the surgeon's description of the pancreatic gland as soft or firm is subjective and often inconsistent. 21 The two main techniques for closure of the pancreatic stump are suture closure of the pancreatic duct or stapled closure of the parenchyma. 22,23 Since it was first described in 1979 it has gained popularity as a simple and effective method of parenchymal transection.…”

Section: Discussionmentioning

confidence: 99%

Utility of drain fluid amylase measurement on the first postoperative day after distal pancreatectomy

Vass

Hodson²,

Isaac

et al. 2018

HPB

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Section: Discussionmentioning

confidence: 99%

Utility of drain fluid amylase measurement on the first postoperative day after distal pancreatectomy

Vass

Hodson²,

Isaac

et al. 2018

HPB

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“…One retrospective study has shown that increased pancreatic density placed patients at a higher risk of PF after distal pancreatectomy. 14 Therefore, a high pancreatic attenuation may be a clinically useful indicator for the development of PF after PD.…”

Section: Discussionmentioning

confidence: 99%

“…Some recent retrospective studies have investigated the association between the degree of pancreatic attenuation on CT and the risk of PF. 14,15 The measurement of pancreatic attenuation is easy and clinically useful; however, these results were limited because of small study populations and the lack of uniformity in the measuring method. Therefore, the aim of the present study was to evaluate the predictive value of pancreatic attenuation for PF after PD using preoperative unenhanced CT images.…”

Section: Introductionmentioning

confidence: 99%

Pancreatic attenuation on computed tomography predicts pancreatic fistula after pancreaticoduodenectomy

Ohgi

Okamura

Sugiura

et al. 2020

HPB

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Background: Some parameters using preoperative computed tomography (CT) have been evaluated to predict the development of pancreatic fistula (PF) after pancreaticoduodenectomy (PD). The present retrospective study evaluated the predictive value of pancreatic attenuation for PF after PD.Methods: A retrospective review was conducted of the patients who underwent PD between January 2010 and December 2014. The pancreatic attenuation was measured in unenhanced preoperative CT images. Pre-and intraoperative variables were analyzed for the risk of PF after PD. Results: Of the 346 consecutive patients, PF occurred in 116 (34%). The pancreatic attenuation was significantly greater in patients with PF than in those without PF (median, 40.0 vs. 33.3 Hounsfield units[HU], P < 0.001). A multivariate analysis showed that a pancreatic attenuation 30.0 HU (odds ratio [OR], 3.72; P < 0.001), a body mass index 25.0 kg/m 2 (OR, 3.67; P < 0.001) and a diameter of the main pancreatic duct <3.0 mm (OR, 1.84; P = 0.034) were independent risk factors for PF after PD. Conclusion:The degree of pancreatic attenuation on preoperative CT images was significantly associated with PF, and a pancreatic attenuation 30.0 HU was an independent risk factor of PF after PD.

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“…The most common postoperative complications are bleeding, infectious complications, delayed gastric emptying syndrome, and pancreatic fistulas [7]. The most serious postoperative complication, with an important impact on the quality of life, is the postoperative pancreatic fistula (POPF), which is responsible for an increased risk of bleeding, abscess, sepsis, and multiple organ failure [2,[8][9][10][11][12][13][14]. Patients with postoperative pancreatic fistulas have an increased risk of local tumor recurrence and a double risk of death [7,11,15,16].…”

Section: Introductionmentioning

confidence: 99%

Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology

Vasilescu

Rusu

Bradea

et al. 2021

Life

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Introduction: Malignant tumors are associated with a low incidence of postoperative pancreatic fistulas. The presence of peritumoral fibrosis is considered the protective factor for the development of postoperative pancreatic fistulas after pancreatic resections for pancreatic ductal adenocarcinomas. Methods: We analyzed a series of 109 consecutive patients with pancreatic resections for malignant pathology: pancreatic ductal adenocarcinomas and periampullary adenocarcinomas. The incidence of postoperative pancreatic fistulas has been reported in tumor histological type, in the presence of peritumoral fibrosis, and in the association between adenocarcinomas and areas of acute pancreatitis. The data obtained were processed with the statistical analysis program SPSS, and statistically significant p were considered at a value <0.05. Results: For the entire study group, the incidence of postoperative pancreatic fistulas was 11.01%. The lowest incidence was observed in the group of patients with pancreatic ductal adenocarcinomas (4.06% vs. 25.72% in the group with periampullary adenocarcinoma), with a p = 0.002. The presence of peritumoral fibrous tissue was observed in 49.31% of cases without pancreatic fistulas, and in 54.54% of cases that developed this postoperative complication (p = 0.5). Also, the peritumoral fibrous tissue had a uniform distribution depending on the main diagnosis (56.14% in pancreatic ductal adenocarcinoma group vs. 37.04% in periampullary adenocarcinoma group, with a p = 0.08). In the group of patients who associated areas of acute pancreatitis on the resections, the incidence of postoperative pancreatic fistulas was 7.8 times higher (30% vs. 3.8%, p = 0.026). Conclusions: Peritumoral fibrous tissue was not a factor involved in the developing of postoperative pancreatic fistulas. The association of adenocarciomas with areas of acute pancreatitis has led to a significant increase in postoperative pancreatic fistulas, which is a significant and independent risk factor.

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Preoperative computed tomography scan to predict pancreatic fistula after distal pancreatectomy using gland and tumor characteristics

Cited by 14 publications

References 26 publications

Utility of drain fluid amylase measurement on the first postoperative day after distal pancreatectomy

Utility of drain fluid amylase measurement on the first postoperative day after distal pancreatectomy

Pancreatic attenuation on computed tomography predicts pancreatic fistula after pancreaticoduodenectomy

Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology

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