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BMC Surgery
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Research

The usefulness of preoperative exocrine function evaluated by the 13C-trioctanoin breath test as a significant physiological predictor of pancreatic fistula after pancreaticoduodenectomy

Authors: Hiroyuki Kato, Yukio Asano, Masahiro Ito, Norihiko Kawabe, Satoshi Arakawa, Masahiro Shimura, Daisuke Koike, Chihiro Hayashi, Kenshiro Kamio, Toki Kawai, Takayuki Ochi, Hironobu Yasuoka, Takahiko Higashiguchi, Daisuke Tochii, Yuka Kondo, Hidetoshi Nagata, Toshiaki Utsumi, Akihiko Horiguchi

Published in: BMC Surgery | Issue 1/2022

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Abstract

Background

The association between pancreatic fistula (PF) after pancreaticoduodenectomy (PD) and preoperative exocrine function is yet to be elucidated. This study aimed to evaluate the association between the preoperative results of the 13C-trioctanoin breath test and the occurrence of PF, showing the clinical relevance of the breath test in predicting PF.

Method

A total of 80 patients who underwent 13C-trioctanoin breath tests prior to PD from 2006 to 2018 were included in this study. Univariate and multivariate analyses were conducted to reveal the preoperative predictors of PF, showing the association between 13C-trioctanoin absorption and PF incidence.

Results

Among 80 patients (age, 68.0 ± 11.9 years, 46 males and 34 females; 30 pancreatic ductal adenocarcinoma [PDAC]/50 non-PDAC patients), the incidence of PF was 12.5% (10/80). Logistic regression analysis results revealed that the frequency of PF increased significantly as the 13C-trioctanoin breath test value (Aa% dose/h) increased (odd’s ratio: 1.082, 95% confidence interval: 1.007–1.162, p = 0.032). Moreover, the optimal cutoff value of the preoperative fat absorption level to predict PF was 38.0 (sensitivity, 90%; specificity, 74%; area under the curve, 0.78; p = 0.005). Indeed, the incidence of PF was extremely higher in patients whose breath test value was greater than 38.0 (33%, 9/27) compared with that in patients with values less than 38.0 (1.8%, 1/53).

Conclusions

Favorable preoperative fat absorption evaluated using the 13C-trioctanoin breath test is a feasible and objective predictor of PF after PD.
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Metadata
Title
The usefulness of preoperative exocrine function evaluated by the 13C-trioctanoin breath test as a significant physiological predictor of pancreatic fistula after pancreaticoduodenectomy
Authors
Hiroyuki Kato
Yukio Asano
Masahiro Ito
Norihiko Kawabe
Satoshi Arakawa
Masahiro Shimura
Daisuke Koike
Chihiro Hayashi
Kenshiro Kamio
Toki Kawai
Takayuki Ochi
Hironobu Yasuoka
Takahiko Higashiguchi
Daisuke Tochii
Yuka Kondo
Hidetoshi Nagata
Toshiaki Utsumi
Akihiko Horiguchi
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01500-7

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