Pancreatic perfusion data and post-pancreaticoduodenectomy outcomes

Abstract Background Precise risk assessment for postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) may be facilitated using imaging modalities. Computed tomography perfusion (CTP) of the pancreas may represent histologic findings. This study aimed to evaluate the utility of C...

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Bibliographic Details
Published in:The Journal of surgical research 2015-04, Vol.194 (2), p.441-449
Main Authors: Sugimoto, Motokazu, MD, PhD, Takahashi, Shinichiro, MD, PhD, Kobayashi, Tatsushi, MD, Kojima, Motohiro, MD, PhD, Gotohda, Naoto, MD, PhD, Satake, Mitsuo, MD, Ochiai, Atsushi, MD, PhD, Konishi, Masaru, MD
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Digestive System Neoplasms - surgery
Female
Fibrosis
Humans
Incidence
Japan - epidemiology
Male
Middle Aged
Pancreas - blood supply
Pancreas - diagnostic imaging
Pancreas - pathology
Pancreas - surgery
Pancreatic CT perfusion
Pancreatic Fistula - epidemiology
Pancreatic Fistula - etiology
Pancreaticoduodenectomy
Pancreaticoduodenectomy - adverse effects
Perfusion Imaging
Postoperative pancreatic fistula
Prospective Studies
Surgery
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Summary:Abstract Background Precise risk assessment for postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) may be facilitated using imaging modalities. Computed tomography perfusion (CTP) of the pancreas may represent histologic findings. This study aimed to evaluate the utility of CTP data for the risk of POPF after PD, in relation to histologic findings. Methods Twenty patients who underwent preoperative pancreatic CTP measurement using 320-detector row CT before PD were investigated. Clinicopathologic findings, including CTP data, were analyzed to assess the occurrence of POPF. In addition, the correlation between CTP data and histologic findings was evaluated. Results POPF occurred in 11 cases (grade A, 6; grade B, 5; and grade C, 0). In CTP data, both high arterial flow (AF) and short mean transit time (MTT) were related to POPF occurrence ( P  = 0.001, P  = 0.001). AF was negatively correlated with fibrosis in the pancreatic parenchyma ( r  = −0.680), whereas MTT was positively correlated with fibrosis ( r  = 0.725). AF >80 mL/min/100 mL and MTT
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2014.11.046