BACKGROUND: The purpose of the study is to evaluate the utility of acoustic radiation force impulse (ARFI) on pancreatic tissue as a preoperative predictor of postoperative pancreatic fistula (POPF). Studied patients underwent exclusively to pancreaticoduodenectomy (PD) surgery. METHODS: Shear wave velocity of pancreas was measured using ARFI in 71 patients scheduled for PD. An intraoperative pancreas palpation was made by surgeons. A postoperative clinical evaluation to detect occurrence of POPF was performed. Sensitivity, specificity, positive and negative predictive values together with the accuracy of the method were investigated. RESULTS: Incidence of fistula observed in 17 patients with soft pancreas was approximately 53% vs. 47% without fistula. Percentage of patients without fistula was higher (66%) among 24 patients with medium parenchymal texture values, and was even higher (69%) in 26 patients with hard pancreas. Comparing ARFI and intraoperative pancreatic palpation, low wave velocity values (≤1.40 m/s) match 60% with soft parenchyma assessed by palpation and high values (>2 m/s) match 59% with hard pancreas on palpation. CONCLUSIONS: This study shows that ARFI elastography may be clinically useful as a preoperative predictor of pancreatic fistula following PD.
BACKGROUND: The purpose of the study is to evaluate the utility of acoustic radiation force impulse (ARFI) on pancreatic tissue as a preoperative predictor of postoperative pancreatic fistula (POPF). Studied patients underwent exclusively to pancreaticoduodenectomy (PD) surgery. METHODS: Shear wave velocity of pancreas was measured using ARFI in 71 patients scheduled for PD. An intraoperative pancreas palpation was made by surgeons. A postoperative clinical evaluation to detect occurrence of POPF was performed. Sensitivity, specificity, positive and negative predictive values together with the accuracy of the method were investigated. RESULTS: Incidence of fistula observed in 17 patients with soft pancreas was approximately 53% vs. 47% without fistula. Percentage of patients without fistula was higher (66%) among 24 patients with medium parenchymal texture values, and was even higher (69%) in 26 patients with hard pancreas. Comparing ARFI and intraoperative pancreatic palpation, low wave velocity values (≤1.40 m/s) match 60% with soft parenchyma assessed by palpation and high values (>2 m/s) match 59% with hard pancreas on palpation. CONCLUSIONS: This study shows that ARFI elastography may be clinically useful as a preoperative predictor of pancreatic fistula following PD.
Authors: Christoph F Dietrich; Sean Burmeister; Stephan Hollerbach; Paolo Giorgio Arcidiacono; Barbara Braden; Pietro Fusaroli; Michael Hocke; Julio Iglesias-Garcia; Masayuki Kitano; Alberto Larghi; Bertrand Napoleon; Kofi W Oppong; Mihai Rimbas; Adrian Saftoiu; Anand V Sahai; Siyu Sun; Yi Dong; Silvia Carrara; Joo Ha Hwang; Christian Jenssen Journal: Endosc Ultrasound Date: 2020 Sep-Oct Impact factor: 5.628