Acinar content at pancreatic resection margin is significantly associated with clinically relevant pancreatic fistula after partial pancreatoduodenectomy

• Published in: Journal of gastrointestinal surgery 2024-03, Vol.28 (3), p.252-258
• Main Authors: Mintziras, Ioannis, Görg, Marvin, Wächter, Sabine, Manoharan, Jerena, Albers, Max Benjamin, Maurer, Elisabeth, Kanngiesser, Veit, Jesinghaus, Moritz, Bartsch, Detlef K.
• Format: Article
• Language: English
• Subjects: Acinar cell; Acinar content; Fibrosis; Humans; Margins of Excision; Pancreas - surgery; Pancreatic Fistula - etiology; Pancreaticoduodenectomy - adverse effects; Pancreatoduodenectomy; Postoperative Complications - etiology; Postoperative pancreatic fistula; Resection margin
• ISSN: 1091-255X; 1873-4626; 1873-4626
• DOI: 10.1016/j.gassur.2023.12.030

This study aimed to evaluate the clinical significance of acinar content at the pancreatic resection margin after partial pancreatoduodenectomy (PD). A total of 228 consecutive patients undergoing PD were included for analysis. Resection margins were assessed for acinar, fibrosis, and fat contents by 2 pathologists blinded to the patients’ clinical data. Univariate and multivariable analyses of possible predictors for clinically relevant postoperative pancreatic fistula (cr-POPF) were performed. The median acinar, fibrosis, and fat contents were 70% (IQR, 25%-82%), 13% (IQR, 5%-40%), and 15% (IQR, 9.25%-25%), respectively. The rates of cr-POPF were significantly higher in patients with an acinar content of >70% than in patients with an acinar content of ≤70% (26.4% vs 5.5%, respectively; P