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

Bag Y. M., Topel C., Ozdemir E., SAĞLAM K., Sumer F., Kayaalp C.

AMERICAN SURGEON, cilt.87, sa.5, ss.725-731, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 87 Sayı: 5
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1177/0003134820952429
  • Dergi Adı: AMERICAN SURGEON
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.725-731
  • Bursa Uludağ Üniversitesi Adresli: Hayır

Özet

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.