Computed tomography in planning of the treatment of complications after pancreatic surgery

Aim. To evaluate opportunity of computed tomography in diagnosis and decision making in patients with pancreatic surgery complications and possibility of interventional procedures in its treatment.Materials and methods. 50 patients underwent pancreatic surgery in 2018-2020 (45 Whipple procedure and 5 distal pancreatectomies). 45 patients underwent computed tomography in post-surgery course. The complications occur in 29 patients; complications were found by computer tomography in 26 patients.Results. The most frequent complication was pancreatic fistula (24%) in typical places: upper edge of the pancreatojejunostomy (25%) and in the bed of the resected pancreatic head (50%). Delineated fluid collections on computed tomography scans were more prevalent in patients with complicated course (57.9% vs. 26.3%). The average size of fluid collections was increased in the group of complicated courses (51,9 × 28,1 mm vs. 42,2 × 20, 6 mm). Interventional procedures were performed in 18 patients (62% of complicated patients). The average number of such interventions per patient was 2.95. Using interventional techniques as the only method of surgical treatment, 13 patients were cured (50% of complicated patients). In 14 patients, interventions were planned and performed based on control computed tomography. Postoperative bleedings were detected in 8 patients (16%). In 4 cases it revealed ongoing bleeding by computer tomography, in 3 cases – completed, which allowed us to determine further treatment tactics.Conclusion. Performing computed tomography after pancreatic surgery allows to identify postoperative complications before their clinical manifestation and plan their treatment. The optimal time for performing computed tomography is 5–6 days after surgery. Performing CT angiography for suspected bleeding in some cases allows to avoid invasive angiography and choose the method of endovascular hemostasis in appropriate situations. The combination of various interventional techniques allows to avoid relaparotomy in most patients with intraabdominal complications.

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Improvement of the Diagnosis of Isoattenuating Pancreatic Carcinomas by Defining their Characteristics on Contrast Enhanced Computed Tomography and Endosonography with Fine-Needle Aspiration (EUS-FNA)

Diagnostics ◽

10.3390/diagnostics11050776 ◽

2021 ◽

Vol 11 (5) ◽

pp. 776

Author(s):

Robert Psar ◽

Ondrej Urban ◽

Marie Cerna ◽

Tomas Rohan ◽

Martin Hill

Keyword(s):

Computed Tomography ◽

Pancreatic Cancer ◽

Pancreatic Duct ◽

Fine Needle Aspiration ◽

Pancreatic Head ◽

Needle Aspiration ◽

Characteristic Analysis ◽

Fine Needle ◽

Contrast Enhanced ◽

Secondary Signs

(1) Background. The aim was to define typical features of isoattenuating pancreatic carcinomas on computed tomography (CT) and endosonography and determine the yield of fine-needle aspiration endosonography (EUS-FNA) in their diagnosis. (2) Methods. One hundred and seventy-three patients with pancreatic carcinomas underwent multiphase contrast-enhanced CT followed by EUS-FNA at the time of diagnosis. Secondary signs on CT, size and location on EUS, and the yield of EUS-FNA in isoattenuating and hypoattenuating pancreatic cancer, were evaluated. (3) Results. Isoattenuating pancreatic carcinomas occurred in 12.1% of patients. Secondary signs of isoattenuating pancreatic carcinomas on CT were present in 95.2% cases and included dilatation of the pancreatic duct and/or the common bile duct (85.7%), interruption of the pancreatic duct (76.2%), abnormal pancreatic contour (33.3%), and atrophy of the distal parenchyma (9.5%) Compared to hypoattenuating pancreatic carcinomas, isoattenuating carcinomas were more often localized in the pancreatic head (100% vs. 59.2%; p < 0.001). In ROC (receiver operating characteristic) analysis, the optimal cut-off value for the size of isoattenuating carcinomas on EUS was ≤ 25 mm (AUC = 0.898). The sensitivity of EUS-FNA in confirmation of isoattenuating and hypoattenuating pancreatic cancer were 90.5% and 92.8% (p = 0.886). (4) Conclusions. Isoattenuating pancreatic head carcinoma can be revealed by indirect signs on CT and confirmed with high sensitivity by EUS-FNA.

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An Assembled Prototype Multimaterial Three-Dimensional–Printed Model of the Neck for Computed Tomography– and Ultrasound-Guided Interventional Procedures

Journal of Computer Assisted Tomography ◽

10.1097/rct.0000000000000630 ◽

2017 ◽

Vol 41 (6) ◽

pp. 941-948 ◽

Cited By ~ 5

Author(s):

Ramin Javan ◽

Alexander L. Cho

Keyword(s):

Computed Tomography ◽

Interventional Procedures ◽

Three Dimensional ◽

Ultrasound Guided

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PERIPROSTHETIC BONE DENSITY CHANGES EVALUATION USING COMPUTED TOMOGRAPHY

Hirurgiâ pozvonočnika ◽

10.14531/ss2005.4.72-76 ◽

2005 ◽

pp. 072-076

Author(s):

Fidele Likibi ◽

Michel Assad ◽

Christine Coillard ◽

Gilles Chabot ◽

Charles-H. . Rivard

Keyword(s):

Computed Tomography ◽

Bone Density ◽

Computer Tomography ◽

Lumbar Fusion ◽

Titanium Implant ◽

Density Variation ◽

Periprosthetic Bone ◽

Sheep Model ◽

Post Implantation

The aim of this study was to examine the effect of the presence of two types of metallic intervertebral lumbar fusion implants (a porous nitinol and a hollow titanium cylindrical implants) in the implant peripheral tissue after 3, 6 and 12 months post-implantation in a lumbar sheep model in order to evaluate and compare the biofunctionality and biocompatibility of both implants. 19 sheep were used to evaluate this bone density variation using computer tomography (CT). 16 of them received both implants at either level L2–L3 or L4–L5 and 3 other non-treated animals were used as controls. Results indicated that PNT obtained a superior biofunctionality that the conventional titanium implant. However, the biocompatibility of porous nitinol seemed comparable to that of titanium – a well-known long-term implant material.

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PANCREATODUODENECTOMY: BRAZILIAN PRACTICE PATTERNS

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201700030007 ◽

2017 ◽

Vol 30 (3) ◽

pp. 190-196 ◽

Cited By ~ 3

Author(s):

Orlando Jorge M TORRES ◽

Eduardo de Souza M FERNANDES ◽

Rodrigo Rodrigues VASQUES ◽

Fabio Luís WAECHTER ◽

Paulo Cezar G. AMARAL ◽

...

Keyword(s):

Pancreatic Surgery ◽

Practice Patterns ◽

International Study ◽

Quality Standard ◽

Somatostatin Analogues ◽

Whipple Procedure ◽

High Quality Standard ◽

High Level ◽

Level Of Experience ◽

Complications And Mortality

ABSTRACT Background: Pancreatoduodenectomy is a technically challenging surgical procedure with an incidence of postoperative complications ranging from 30% to 61%. The procedure requires a high level of experience, and to minimize surgery-related complications and mortality, a high-quality standard surgery is imperative. Aim: To understand the Brazilian practice patterns for pancreatoduodenectomy. Method: A questionnaire was designed to obtain an overview of the surgical practice in pancreatic cancer, specific training, and experience in pancreatoduodenectomy. The survey was sent to members who declared an interest in pancreatic surgery. Results: A total of 60 questionnaires were sent, and 52 have returned (86.7%). The Southeast had the most survey respondents, with 25 surgeons (48.0%). Only two surgeons (3.9%) performed more than 50% of their pancreatoduodenectomies by laparoscopy. A classic Whipple procedure was performed by 24 surgeons (46.2%) and a standard International Study Group on Pancreatic Surgery lymphadenectomy by 43 surgeons (82.7%). For reconstruction, pancreaticojejunostomy was performed by 49 surgeons (94.2%), single limb technique by 41(78.9%), duct-to-mucosa anastomosis by 38 (73.1%), internal trans-anastomotic stenting by 26 (50.0%), antecolic route of gastric reconstruction by 39 (75.0%), and Braun enteroenterostomy was performed by only six surgeons (11.5%). Prophylactic abdominal drainage was performed by all surgeons, and somatostatin analogues were utilized by six surgeons (11.5%). Early postoperative enteral nutrition was routine for 22 surgeons (42.3%), and 34 surgeons (65.4%) reported routine use of a nasogastric suction tube. Conclusion: Heterogeneity was observed in the pancreatoduodenectomy practice patterns of surgeons in Brazil, some of them in contrast with established evidence in the literature.

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Value of Spectral Detector Computed Tomography to differentiate Infected from Noninfected Thoracoabominal Fluid Collections

European Journal of Radiology ◽

10.1016/j.ejrad.2021.110037 ◽

2021 ◽

pp. 110037

Author(s):

Robert Peter Reimer ◽

Roman Johannes Gertz ◽

Lenhard Pennig ◽

Jörn Henze ◽

Erkan Celik ◽

...

Keyword(s):

Computed Tomography ◽

Fluid Collections

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Drug Therapy in Computed-Tomography-Guided Interventional Procedures

Interventional Radiology ◽

10.1007/978-3-662-01654-1_15 ◽

1993 ◽

pp. 163-172

Author(s):

A. Jacob ◽

W. Steinbrich

Keyword(s):

Computed Tomography ◽

Drug Therapy ◽

Interventional Procedures

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Use of computed tomography data for forensic identification of an individual

Russian Journal of Forensic Medicine ◽

10.19048/fm339 ◽

2020 ◽

Vol 6 (4) ◽

pp. 41-45

Author(s):

Sergey V. Leonov ◽

Julia P. Shakiryanova

Keyword(s):

Computed Tomography ◽

Computer Tomography ◽

Soft Tissues ◽

Three Dimensional ◽

Reference Points ◽

Forensic Identification ◽

Dimensional Model ◽

Three Dimensional Model ◽

The Face ◽

Tomography Data

Background: The article presents our own experience of using computer tomography for identification of individuals with known results. Aims: The aim of the study was to verify the possibility of performing an identification study using a three-dimensional model obtained from computed tomography of the head. Identification was performed using a three-dimensional model of the head, based on computer tomography sections made in various projections, with a step of 1.231.25 mm. Two-dimensional images of the face (photos) were used for comparison. All comparative studies were conducted using approved methods of craniofacial and portrait identification: by reference points and contours. The experiment used a computer program that allows you to export DICOM-files of computed tomography results to other formats (InVesalius), as well as computer programs that directly work with the research objects (Autodesk 3ds Max, alternative programs Adobe Photoshop, Smith Micro Poser Pro). Results: In the course of research, it was found that, having computer tomography data of the head, it is possible to conduct identification studies on the following parameters: on the reconstructed three-dimensional model of the soft tissues of the face, on the three-dimensional model of the skull (craniofacial identification), on the features of the structure of the ear. Conclusion: Positive results were obtained when comparing objects, which makes it advisable to use them in practical and scientific activities.

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