Pancreatic duct size and gland texture are associated with pancreatic fistula after pancreaticoduodenectomy but not after distal pancreatectomy

Pancreatic fistula remains a morbid complication after pancreatectomy. Since the proposed mechanism of pancreatic fistula is different between pancreaticoduodenectomy and distal pancreatectomy, we hypothesized that pancreatic gland texture and duct size are not associated with pancreatic fistula aft...

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Bibliographic Details
Published in:PloS one 2018-09, Vol.13 (9), p.e0203841-e0203841
Main Authors: Martin, Allison N, Narayanan, Sowmya, Turrentine, Florence E, Bauer, Todd W, Adams, Reid B, Zaydfudim, Victor M
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Clinical trials
Complications
Datasets
Fistula
Fistulae
Ligaments
Medical personnel
Medicine and Health Sciences
Pancreas
Pancreatectomy
Pancreaticoduodenectomy
Patients
Quality control
Risk factors
Surgery
Surgical outcomes
Texture
Variables
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Summary:Pancreatic fistula remains a morbid complication after pancreatectomy. Since the proposed mechanism of pancreatic fistula is different between pancreaticoduodenectomy and distal pancreatectomy, we hypothesized that pancreatic gland texture and duct size are not associated with pancreatic fistula after distal pancreatectomy. All patients ≥18 years in the 2014-15 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) targeted pancreatectomy dataset were linked with the ACS NSQIP Public Use File (PUF). Pancreatic duct size (6 mm) and pancreatic gland texture (hard, intermediate, soft) were categorized. Separate multivariable analyses were performed to evaluate associations between pancreatic duct size and gland texture after pancreaticoduodenectomy and distal pancreatectomy. A total of 9366 patients underwent pancreaticoduodenectomy or distal pancreatectomy during the study period. Proportion of pancreatic fistula was similar after distal pancreatectomy (606 of 3132, 19.4%) and pancreaticoduodenectomy (1163 of 6335, 18.4%, p = 0.245). Both pancreatic gland texture and duct size were significantly associated with pancreatic fistula after pancreaticoduodenectomy (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0203841