Yuichiro Uchida1, Toshihiko Masui2, Asahi Sato1, Kazuyuki Nagai1, Takayuki Anazawa1, Kyoichi Takaori1, Shinji Uemoto1. 1. Division of Hepatobiliary Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, Syogoinkawaharacho 54, Sakyo-ku, Kyoto, Japan. 2. Division of Hepatobiliary Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, Syogoinkawaharacho 54, Sakyo-ku, Kyoto, Japan. tmasui@kuhp.kyoto-u.ac.jp.
Abstract
BACKGROUND: Peripancreatic collections occur frequently after distal pancreatectomy. However, the sequelae of peripancreatic collections vary from case to case, and their clinical impact is uncertain. In this study, the correlations between CT findings of peripancreatic collections and complications after distal pancreatectomy were investigated. METHODS: Ninety-six consecutive patients who had undergone distal pancreatectomy between 2010 and 2015 were retrospectively investigated. The extent and heterogeneity of peripancreatic collections and background clinicopathological characteristics were analyzed. The extent of peripancreatic collections was calculated based on three-dimensional computed tomography images, and the degree of heterogeneity of peripancreatic collections was assessed based on the standard deviation of their density on computed tomography. RESULTS: Of 85 patients who underwent postoperative computed tomography imaging, a peripancreatic collection was detected in 77 (91%). Patients with either a large extent or a high degree of heterogeneity of peripancreatic collection had a significantly higher rate of clinically relevant pancreatic fistula than those without (odds ratio 5.95, 95% confidence interval 2.12-19.72, p = 0.001; odds ratio 8.0, 95% confidence interval 2.87-24.19, p = 0.0001, respectively). CONCLUSIONS: A large and heterogeneous peripancreatic collection was significantly associated with postoperative complications, especially clinically relevant postoperative pancreatic fistula. A small and homogenous peripancreatic collection could be safely observed.
BACKGROUND: Peripancreatic collections occur frequently after distal pancreatectomy. However, the sequelae of peripancreatic collections vary from case to case, and their clinical impact is uncertain. In this study, the correlations between CT findings of peripancreatic collections and complications after distal pancreatectomy were investigated. METHODS: Ninety-six consecutive patients who had undergone distal pancreatectomy between 2010 and 2015 were retrospectively investigated. The extent and heterogeneity of peripancreatic collections and background clinicopathological characteristics were analyzed. The extent of peripancreatic collections was calculated based on three-dimensional computed tomography images, and the degree of heterogeneity of peripancreatic collections was assessed based on the standard deviation of their density on computed tomography. RESULTS: Of 85 patients who underwent postoperative computed tomography imaging, a peripancreatic collection was detected in 77 (91%). Patients with either a large extent or a high degree of heterogeneity of peripancreatic collection had a significantly higher rate of clinically relevant pancreatic fistula than those without (odds ratio 5.95, 95% confidence interval 2.12-19.72, p = 0.001; odds ratio 8.0, 95% confidence interval 2.87-24.19, p = 0.0001, respectively). CONCLUSIONS: A large and heterogeneous peripancreatic collection was significantly associated with postoperative complications, especially clinically relevant postoperative pancreatic fistula. A small and homogenous peripancreatic collection could be safely observed.
Authors: Claudio Bassi; Giovanni Marchegiani; Christos Dervenis; Micheal Sarr; Mohammad Abu Hilal; Mustapha Adham; Peter Allen; Roland Andersson; Horacio J Asbun; Marc G Besselink; Kevin Conlon; Marco Del Chiaro; Massimo Falconi; Laureano Fernandez-Cruz; Carlos Fernandez-Del Castillo; Abe Fingerhut; Helmut Friess; Dirk J Gouma; Thilo Hackert; Jakob Izbicki; Keith D Lillemoe; John P Neoptolemos; Attila Olah; Richard Schulick; Shailesh V Shrikhande; Tadahiro Takada; Kyoichi Takaori; William Traverso; Charles R Vollmer; Christopher L Wolfgang; Charles J Yeo; Roberto Salvia; Marcus Buchler Journal: Surgery Date: 2016-12-28 Impact factor: 3.982
Authors: Claudio Bassi; Enrico Molinari; Giuseppe Malleo; Stefano Crippa; Giovanni Butturini; Roberto Salvia; Giorgio Talamini; Paolo Pederzoli Journal: Ann Surg Date: 2010-08 Impact factor: 12.969
Authors: Matthias Hassenpflug; Ulf Hinz; Oliver Strobel; Johanna Volpert; Philip Knebel; Markus K Diener; Colette Doerr-Harim; Jens Werner; Thilo Hackert; Markus W Büchler Journal: Ann Surg Date: 2016-11 Impact factor: 12.969
Authors: M C Giglio; D R C Spalding; A Giakoustidis; A Zarzavadjian Le Bian; L R Jiao; N A Habib; M Pai Journal: Br J Surg Date: 2016-01-21 Impact factor: 6.939
Authors: Peter A Banks; Thomas L Bollen; Christos Dervenis; Hein G Gooszen; Colin D Johnson; Michael G Sarr; Gregory G Tsiotos; Santhi Swaroop Vege Journal: Gut Date: 2012-10-25 Impact factor: 23.059
Authors: F Jasmijn Smits; Anne Claire Henry; Casper H van Eijck; Marc G Besselink; Olivier R Busch; Mark Arntz; Thomas L Bollen; Otto M van Delden; Daniel van den Heuvel; Christiaan van der Leij; Krijn P van Lienden; Adriaan Moelker; Bert A Bonsing; Inne H M Borel Rinkes; Koop Bosscha; R M van Dam; Sebastiaan Festen; B Groot Koerkamp; Erwin van der Harst; Ignace H de Hingh; Geert Kazemier; Mike Liem; B Marion van der Kolk; Vincent E de Meijer; Gijs A Patijn; Daphne Roos; Jennifer M Schreinemakers; Fennie Wit; C Henri van Werkhoven; I Quintus Molenaar; Hjalmar C van Santvoort Journal: Trials Date: 2020-05-07 Impact factor: 2.279