A Novel Radiological Predictor for Postoperative Pancreatic Fistula After Stapled Distal Pancreatectomy

2020 ◽  
pp. 000313482095242
Author(s):  
Yusuf Murat Bag ◽  
Cagdas Topel ◽  
Egemen Ozdemir ◽  
Kutay Saglam ◽  
Fatih Sumer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Predictive Factor ◽  
Multivariate Analyses ◽  
Postoperative Pancreatic Fistula ◽  
Factors Affecting ◽  
Malignant Lesions ◽  
Pancreatic Thickness ◽  
Narrow Duct

Background Distal pancreatectomy (DP) is the main surgical treatment of benign and malignant lesions located in pancreatic body and tail. Postoperative pancreatic fistula (POPF) following DP is still a considerable cause of morbidity. Identification of risk factors for POPF after DP might provide some preventive applications. We aimed to evaluate the factors affecting POPF after DP and to present a new and easy radiological predictive factor. Materials and Methods Thirty-four patients underwent DP with stapler closure were included. Several risk factors for clinically relevant POPF (CR-POPF) were analyzed. Additionally, computed tomography findings of pancreatic thickness (PT), main pancreatic duct diameter (MPDD), and PT/MPDD ratio were evaluated for POPF. Results CR-POPF was observed in 10 patients (29.4%). Univariate and multivariate analyses showed that previous abdominal surgery and PT/MPDD ratio were predictive factors for CR-POPF after DP ( P = 0.040, P = 0.034, respectively). The cutoff value for the PT/MPDD ratio was 8. Conclusion A PT/MPDD ratio greater than 8 (a wide pancreas with a narrow duct) is a significant predictive factor for CR-POPF following DP.

Pancreatic thickness as a predictive factor for postoperative pancreatic fistula after distal pancreatectomy using an endopath stapler

Surgery Today ◽  
2012 ◽  
Vol 43 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Keiichi Okano ◽  
Minoru Oshima ◽  
Keitaro Kakinoki ◽  
Naoki Yamamoto ◽  
Shintaro Akamoto ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Predictive Factor ◽  
Postoperative Pancreatic Fistula ◽  
Pancreatic Thickness

scholarly journals Pancreatic fistula risk assessment after distal pancreatectomy: a retrospective controlled study

2021 ◽  
Vol 28 (2) ◽  
pp. 33-45
Author(s):  
E. S. Drozdov ◽  
E. B. Topolnitskiy ◽  
S. S. Klokov ◽  
T. V. Dibina
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Main Pancreatic Duct ◽  
Postoperative Pancreatic Fistula ◽  
Controlled Study ◽  
Morphological Examination ◽  
Distal Pancreatic Resection ◽  
Duct Diameter

Background. Despite declining mortality, postoperative pancreatic fistula (PPF) remains a common complication of distal pancreatic resection surgery challenging to clinical prediction.Objectives. Prognostic analysis of the postoperative pancreatic fistula risk factors in patients with previous distal pancreatectomy.Methods. A retrospective controlled assay enrolled 107 patients, including 63 (58.9%) male and 44 (41.1%) female patients. All patients underwent distal pancreatectomy followed by a morphological examination of resected material. All patients had a general and biochemical blood panel profiling. Pancreatic tissue density at a putative resection zone was assessed with computed tomography. The patients were allocated to two cohorts: (1) not developing PPF (77 patients) and (2) having postoperative PPF complications (30 patients.Results. No statistically significant differences by age, gender, ASA and BMI scores were observed in study cohorts. Multivariate analysis revealed a statistically significant correlation of the PPF rate with the following factors: main pancreatic duct diameter <3 mm (odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01–1.05, p = 0.01), pancreatic density at putative resection zone <30 HU in CT (OR 3.18, 95% CI 1.38–7.74, p < 0.01) and differential albumin of postoperative day 1 vs. pre-surgery >14 g/L (OR 3.13, 95% CI 1.19–8.24, p < 0.01).Conclusion. A main pancreatic duct diameter <3 mm, pancreatic density at putative resection zone <30 HU in CT and differential albumin of postoperative day 1 vs. pre-surgery >14 g/L are independent risk factors of postoperative fistulae.

Risk Factors for Postoperative Pancreatic Fistula in Distal Pancreatectomy

2011 ◽  
Vol 58 (109) ◽  
pp. 1372-1376 ◽  
Author(s):  
Koji Soga ◽  
Toshiya Ochiai ◽  
Teruhisa Sonoyama ◽  
Koji Inoue ◽  
Hisashi Ikoma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Postoperative Pancreatic Fistula

scholarly journals Risk factors of postoperative pancreatic fistula after distal pancreatectomy using a triple-row stapler

Surgery Today ◽  
2017 ◽  
Vol 48 (1) ◽  
pp. 95-100 ◽  
Author(s):  
Hiromichi Kawaida ◽  
Hiroshi Kono ◽  
Mitsuaki Watanabe ◽  
Naohiro Hosomura ◽  
Hidetake Amemiya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Postoperative Pancreatic Fistula

The risk factors of postoperative pancreatic fistula after distal pancreatectomy

Pancreatology ◽  
2016 ◽  
Vol 16 (4) ◽  
pp. S127
Author(s):  
Ryutaro Mori ◽  
Ryusei Matsuyama ◽  
Yohei Ota ◽  
Seigo Hiratani ◽  
Koki Goto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Postoperative Pancreatic Fistula

scholarly journals Risk Factors of Pancreatic Fistula in Distal Pancreatectomy Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Amyna Jiwani ◽  
Tabish Chawla
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Surgical Techniques ◽  
Multivisceral Resection ◽  
Postoperative Pancreatic Fistula ◽  
The Body ◽  
Fistula Formation ◽  
Factors Associated

Introduction. Benign and malignant lesions of the pancreas located at the body and tail of the pancreas are managed by the standard procedure of distal pancreatectomy (DP). The mortality associated with this procedure is reported as less than 5% in high-volume centers. The major proportion of morbidity is comprised of pancreatic fistula with a reported incidence of 5% to 60%. The most considered risk factors associated with pancreatic fistula formation are soft pancreatic texture, diameter of the pancreatic duct <3 mm, intraoperative blood loss >1000 ml and surgical techniques. Among all these factors, the modifiable factor is the surgical technique. Several surgical techniques have been developed and modified for closure of the pancreatic remnant in the recent past in order to minimize the risk of pancreatic fistula and other complications. The main objective of the study is to analyze the factors associated with formation of pancreatic fistula after distal pancreatectomy. Patients and Methods. We performed a single-center retrospective study at Aga Khan University Hospital from January 2004 till December 2015. The perioperative and postoperative data of 131 patients who underwent pancreatic resection were recorded by using ICD 9 coding. 45 patients underwent distal pancreatectomy, out of which 38 were included in the study based on inclusion criteria. Variables were grouped into demographics, indications, operative details, and postoperative course. Statistical analysis software (SPSS) was used for analysis. Quantitative variables were presented as mean with standard deviation or median with interquartile range depending on the distribution of data. Study endpoints for the risk factor analysis were surgical morbidity and development of pancreatic fistula. Univariate logistic regressions were performed associated with study endpoints. P value less than 0.05 was considered significant. Results. Postoperative pancreatic fistula was the most common perioperative morbidity. The significant associated risk factor for pancreatic fistula was multivisceral resection as compared to spleen-preserving distal pancreatectomy (P value 0.039). However, the technique of stump closure when opted for suture techniques was seen to be associated with a higher occurrence of postoperative pancreatic fistula. The mortality rate was 2.6%. Conclusion. Postoperative pancreatic fistula is the most common complication seen after distal pancreatectomy in our series. Multivisceral resection is associated with a high incidence of pancreatic fistula and is a statistical significant predictor of pancreatic fistula.

Distal Pancreatectomy for Chronic Pancreatitis: Risk Factors for Postoperative Pancreatic Fistula

2007 ◽  
Vol 11 (8) ◽  
pp. 991-997 ◽  
Author(s):  
Thomas Schnelldorfer ◽  
Patrick D. Mauldin ◽  
David N. Lewin ◽  
David B. Adams
Keyword(s):  
Risk Factors ◽  
Chronic Pancreatitis ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Postoperative Pancreatic Fistula
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