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01-08-2019 | Computed Tomography | Original Scientific Report

The Clinical Implications of Peripancreatic Fluid Collection After Distal Pancreatectomy

Authors: Jun Yoshino, Daisuke Ban, Toshiro Ogura, Kosuke Ogawa, Hiroaki Ono, Yusuke Mitsunori, Atsushi Kudo, Shinji Tanaka, Minoru Tanabe

Published in: World Journal of Surgery | Issue 8/2019

Abstract

Objectives

Pancreatic fistula after distal pancreatectomy (DP) remains an unsolved problem, and postoperative CT imaging often demonstrates fluid collection (FC) around the pancreatic remnant. This study sought to clarify the clinical implications of FC.

Methods

This study enrolled 146 patients who underwent DP. FC was defined as a cyst-like lesion ≥ 10 mm in diameter on CT imaging at postoperative day (POD) 7. FC size, irregularity of FC margin, and air bubbles in FC were investigated. In addition, clinical data were retrospectively collected, and useful predictive factors for postoperative pancreatic fistula (POPF) were analyzed.

Results

Clinically relevant POPF was observed in 26 patients (17.8%), and FC was detected in 136 patients (94.4%). Multivariate analysis identified FC size and drain amylase levels on POD3 as significant risk factors for POPF. Cutoff values were determined by ROC analyses, and the levels of the FC size and drain amylase on POD3 were determined as 41 mm and 1026 IU/L, respectively. The sensitivity and specificity of FC diameters > 41 mm were 76.9% and 75.0%, respectively, while those of drain amylase levels > 1026 IU on POD3 were 73.1% and 75.8%, respectively.

Conclusions

While treating some FCs after DP was necessary for the management of POPF, others did not require any intervention since most of them spontaneously disappeared. FC size and drain amylase levels on POD3 were found to be significantly associated with POPF and could potentially help to determine appropriate treatment.

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Title: The Clinical Implications of Peripancreatic Fluid Collection After Distal Pancreatectomy
Authors: Jun Yoshino
Daisuke Ban
Toshiro Ogura
Kosuke Ogawa
Hiroaki Ono
Yusuke Mitsunori
Atsushi Kudo
Shinji Tanaka
Minoru Tanabe
Publication date: 01-08-2019
Publisher: Springer International Publishing
Keywords: Computed Tomography
Pancreatectomy
Computed Tomography
Published in: World Journal of Surgery / Issue 8/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05009-8

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The Clinical Implications of Peripancreatic Fluid Collection After Distal Pancreatectomy

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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