A comparative study of risk factors for pancreatic fistula after pancreatoduodenectomy or distal pancreatectomy

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
James M Halle-SmithKeith J Roberts

Abstract

Evidence associates various biometric and histological variables such as steatosis and absence of fibrosis as risk factors for post-operative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). Following distal pancreatectomy (DP), the association between these factors and POPF is less clear. This study of patients, drawn from the same background population, undergoing PD or DP at a single centre is a comparative study of the risk factors for POPF after these two operations. Associations between POPF and patient characteristics, pre-operative blood tests, data from pre-operative computed tomography (CT) imaging, assessment of histological steatosis and fibrosis were explored. 26/107 (24%) and 26/90 (29%) patients developed POPF after PD and DP respectively. Absence of fibrosis was associated with POPF (p < 0.001) after PD and its presence correlated with pancreatic duct width (p < 0.001). Steatosis was not associated with POPF (p = 0.910). Multivariable analysis showed pancreatic duct width (p = 0.016) and fibrosis (p = 0.025) to be independent predictors of POPF after PD. The only variable associated with POPF after DP was underlying pathology (p = 0.005). Pancreatic duct width is the most important variable related to...Continue Reading

Citations

Oct 3, 2019·Abdominal Radiology·Kedar G SharbidreDesiree E Morgan
May 13, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Lyonell B KoneAjay V Maker
Apr 7, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Eric ChongSanjay Pandanaboyana
Nov 1, 2018·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Christopher B NahmAnubhav Mittal

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