Acta Medica Okayama volume74 issue4
2020-08 発行

The Late Phase/Early Phase Ratio of Pancreatic CT Values as a Novel Predictor of Pancreatic Fistula after Distal Pancreatectomy

Utsumi, Masashi Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Aoki, Hideki Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Yabuki, Takayuki Department of Radiology, National Hospital Organization, Iwakuni Clinical Center
Nagahisa, Seiichi Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Nishimura, Seitaro Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Une, Yuta Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Kimura, Yuji Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Watanabe, Megumi Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Taniguchi, Fumitaka Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Arataa, Takashi Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Katsuda, Koh Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Tanakaya, Kohji Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Sato, Yumiko Department of Pathology, National Hospital Organization, Iwakuni Clinical Center
Publication Date
2020-08
Abstract
Post-operative pancreatic fistula (POPF) remains the most common complication after distal pancreatectomy (DP). In this retrospective study, we reviewed the data from patients who underwent DP between 2008 and 2019 in our institute to determine whether the late phase/early phase ratio (L/E ratio) by preoperative computed tomography (CT) scan in the pancreas could predict POPF occurrence after DP. We examined the relationship between preoperative or intraoperative factors and the occurrence of POPF after DP using statistical methods in 23 males and 21 females with a mean age of 73. The mean L/E ratio was significantly lower in the POPF group than the non-POPF group (p=0.035). The L/E ratio had moderate diagnostic accuracy, with a calculated optimal cutoff value of 0.77. In univariate analysis, a significant association was noted between POPF and stump thickness ≥ 16.9, body mass index ≥ 27.5, and L/E ratio ≤ 0.77. In the multivariate analysis, the L/E ratio (odds ratio, 5.96; p=0.036) was an independent risk factor for POPF. Our findings suggest that the pancreatic L/E ratio may predict the occurrence of POPF after DP. This measure may be useful in preoperative risk stratification, patient counseling, and perioperative patient management, improving clinical outcomes after DP.
Document Type
Original Article
Keywords
late phase/early phase ratio
pancreatic fistula
distal pancreatectomy
Link to PubMed
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