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World Journal of Surgery

Published in:

01-09-2014

Correlation between Preoperative Imaging and Intraoperative Risk Assessment in the Prediction of Postoperative Pancreatic Fistula Following Pancreatoduodenectomy

Authors: Farshad Frozanpor, Louiza Loizou, Christoph Ansorge, Lars Lundell, Nils Albiin, Ralf Segersvärd

Published in: World Journal of Surgery | Issue 9/2014

Abstract

Background

Prediction of postoperative pancreatic fistula (POPF) can be carried out with the intraoperative assessment of pancreatic consistency (PC) and via pancreatic duct width (iPDW). Preoperative computed tomography (CT) calculated pancreatic remnant volume (PRV) and duct width (rPDW) have also been shown to offer useful information about the risk of POPF.

Objective

The objective of this study was to determine the predictive value of the preoperative radiological features as compared with the intraoperative risk estimation for the subsequent development of POPF.

Method

All patients undergoing pancreatoduodenectomy between September 2007 and March 2012 at the Karolinska University Hospital Stockholm were included. PRV and rPDW were determined on preoperative CT and in parallel, intraoperative PC and iPDW of the remnant pancreas were independently assessed.

Results

A total of 296 consecutive pancreatoduodenectomies were included. POPF occurred in 45 patients (15.2 %). Of those with a preoperatively calculated PRV < 23.0 cm³, 2.8 % developed POPF compared with 25.7 % of those with a corresponding volume > 46.0 cm³. In patients with an rPDW > 7.0 mm, 4.1 % had a POPF as compared with 38.7 % for those with rPDW < 2.0 mm. The POPF risk estimates based on PRV and rPDW and the intraoperative risk assessments were found to be identical (p < 0.001). In the receiver operating characteristic analysis, area under the curve was 0.80 (95 % confidence interval [CI] 0.72–0.87) and 0.80 (95 % CI 0.72–0.88) for the CT-based and intraoperative risk prediction models, respectively.

Conclusions

Preoperative CT-based and intraoperative gland risk assessments offer comparable predictive information on the risk of POPF after pancreatoduodenectomy. These results imply that accurate POPF risk estimation can be carried out in the preoperative setting to opt for improved patient selection into relevant research protocols and the availability of surgical expertise and techniques.

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Title: Correlation between Preoperative Imaging and Intraoperative Risk Assessment in the Prediction of Postoperative Pancreatic Fistula Following Pancreatoduodenectomy
Authors: Farshad Frozanpor
Louiza Loizou
Christoph Ansorge
Lars Lundell
Nils Albiin
Ralf Segersvärd
Publication date: 01-09-2014
Publisher: Springer US
Published in: World Journal of Surgery / Issue 9/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-014-2556-5

2024 ASCO Annual Meeting

Springer Medicine

Correlation between Preoperative Imaging and Intraoperative Risk Assessment in the Prediction of Postoperative Pancreatic Fistula Following Pancreatoduodenectomy

Abstract

Background

Objective

Method

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Objective

Method

Results

Conclusions

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