Significance of Preoperative Pancreatic MRI Findings in Predicting Factors for Postoperative Pancreatic Fistula after Distal Pancreatectomy for Pancreatic Cancer: A Retrospective Study

Abstract Background: Postoperative pancreatic fistula (POPF) is the most serious complication of distal pancreatectomy (DP). For patients with pancreatic cancer (PC), POPF can have a negative effect on both short- and long-term prognoses. This study aimed to identify clinical outcomes of POPF after DP for PC and predictive factors for POPF.Methods: This retrospective, single-institution study comprised 48 patients with PC who underwent open DP (excluding simultaneous resection of other organs and other pancreatic diseases) between January 2010 and December 2020 at the Gifu University Hospital. We statistically analyzed patient-, pancreas-, cancer-, and surgery-related factors for predicting outcomes and risk factors for POPF. Results: According to the International Study Group of Pancreatic Fistula (ISGPF) definition and grading, 11 (22.9%) of 48 patients had POPF grades B and C. Among 22 related factors, POPF was significantly associated with pancreatic width (p = 0.04) and the pancreas-to-muscle signal intensity ratio (SIR) on T1-weighted magnetic resonance imaging (MRI, p = 0.02) in univariate analysis. In multivariate analysis, both pancreatic width (≥23 mm, odds ratio [OR] 9.37; 95% confidence interval [CI] 1.22–202.40; p = 0.03) and SIR on T1-weighted MRI (≥1.37, OR 17.10; 95% CI 2.38–359.04; p = 0.003) were identified as independent predictive factors for POPF. Conclusion: Pancreatic width and pancreas-to-muscle SIR on T1-weighted MRI significantly correlated with POPF after DP for PC. These parameters may be potential imaging biomarkers for predicting POPF in pancreatic surgery.

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Predictive factors associated with postoperative pancreatic fistula after laparoscopic distal pancreatectomy: a 10-year single-institution experience

Surgical Endoscopy ◽

10.1007/s00464-015-4255-1 ◽

2015 ◽

Vol 30 (2) ◽

pp. 649-656 ◽

Cited By ~ 20

Author(s):

Arturo S. Mendoza ◽

Ho-Seong Han ◽

Soyeon Ahn ◽

Yoo-Seok Yoon ◽

Jai Young Cho ◽

...

Keyword(s):

Pancreatic Fistula ◽

Distal Pancreatectomy ◽

Predictive Factors ◽

Laparoscopic Distal Pancreatectomy ◽

Postoperative Pancreatic Fistula ◽

Single Institution ◽

Factors Associated

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Distal Pancreatectomy Utilizing a Flexible Stapler Closure Eliminates the Risk of Pancreas-Related Factors for Postoperative Pancreatic Fistula

European Surgical Research ◽

10.1159/000349977 ◽

2013 ◽

Vol 50 (2) ◽

pp. 71-79 ◽

Cited By ~ 12

Author(s):

Y. Kawabata ◽

T. Nishi ◽

T. Tanaka ◽

S. Yano ◽

Y. Tajima

Keyword(s):

Pancreatic Fistula ◽

Distal Pancreatectomy ◽

Postoperative Pancreatic Fistula ◽

Related Factors

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Risk Factors for Clinically Relevant Postoperative Pancreatic Fistula (CR-POPF) after Distal Pancreatectomy: A Single Center Retrospective Study

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2021/8874504 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Gao Qing Wang ◽

Dipesh Kumar Yadav ◽

Wei Jiang ◽

Yong Fei Hua ◽

Cai De Lu

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Pancreatic Fistula ◽

Pancreatic Duct ◽

Distal Pancreatectomy ◽

Main Pancreatic Duct ◽

Surgical Complication ◽

Univariate Analysis ◽

Postoperative Pancreatic Fistula ◽

Soft Pancreas

Objectives. Clinically relevant postoperative pancreatic fistula (CR-POPF) is the considerable contributor to major complications after pancreatectomy. The purpose of this study was to evaluate the potential risk factor contributing to CR-POPF following distal pancreatectomy (DP) and discuss the risk factors of pancreatic fistula in order to interpret the clinical importance. Methods. In this retrospective study, 263 patients who underwent DP at Ningbo Medical Center Li Huili Hospital between January 2011 and January 2020 were reviewed in accordance with relevant guidelines and regulations. Patients’ demographics and clinical parameters were evaluated using univariate and multivariate analyses to identify the risk factors contributing to CR-POPF. P < 0.05 was considered statistically significant. Results. In all of the 263 patients with DP, pancreatic fistula was the most common surgical complication (19.0%). The univariate analysis of 18 factors showed that the patients with a malignant tumor, soft pancreas, and patient without ligation of the main pancreatic duct were more likely to develop pancreatic fistula. However, on multivariate analysis, the soft texture of the pancreas (OR = 2.381, 95% CI = 1.271–4.460, P = 0.001 ) and the ligation of the main pancreatic duct (OR = 0.388, 95% CI = 0.207–0.726, P = 0.002 ) were only an independent influencing factor for CR-POPF. Conclusions. As a conclusion, pancreatic fistula was the most common surgical complication after DP. The soft texture of the pancreas and the absence of ligation of the main pancreatic duct can increase the risk of CR-POPF.

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Risk Factors for Clinically Relevant Postoperative Pancreatic Fistula (CR-POPF) after Distal Pancreatectomy: A Single Center Experience

10.1101/2020.05.04.20090241 ◽

2020 ◽

Author(s):

Gao Qing Wang ◽

Dipesh Kumar Yadav ◽

Wei Jiang ◽

Yong Fei Hua ◽

Cai De Lu

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Pancreatic Fistula ◽

Pancreatic Duct ◽

Distal Pancreatectomy ◽

Main Pancreatic Duct ◽

Surgical Complication ◽

Univariate Analysis ◽

Postoperative Pancreatic Fistula ◽

Soft Pancreas

AbstractClinically relevant postoperative pancreatic fistula (CR-POPF) is the considerable contributor to major complications after pancreatectomy. The purpose of this study was to evaluate the potential risk factor contributing to CR-POPF following distal pancreatectomy (DP) and discussed the risk factors of pancreatic fistula in order to interpret the clinical importance. All the patients who underwent DP in between January 2011 and January 2020 were reviewed retrospectively in accordance with relevant guidelines and regulations. The univariate and multivariate analysis was performed was performed to test an independent risk factors for pancreatic fistula. P<0.05 was considered statistically significant. In all of the 263 patients with DP, pancreatic fistula was the most common surgical complication 19.0%. The univariate analysis of 18 factors showed that the patients with a malignant tumor, soft pancreas, and patient without ligation of the main pancreatic duct are more likely to develop pancreatic fistula. However, on multivariate analysis the soft texture of the pancreas (OR= 2.381, P= 0.001) and the ligation of main pancreatic duct (OR= 0.388, P= 0.002) were only an independent influencing factor for CR-POPF. As a conclusion, pancreatic fistula was the most common surgical complication after DP, and the texture of pancreas and ligation of main pancreatic duct can influence an incidence of CR-POPF.

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