Quantification of pancreatic stiffness on intraoperative ultrasound elastography and evaluation of its relationship with postoperative pancreatic fistula

International Surgery
Masahide HatanoYasutsugu Takada

Abstract

"Soft pancreas" has often been reported as a predictive factor for postoperative pancreatic fistula (POPF) after pancreatectomy. However, pancreatic stiffness is judged subjectively by surgeons, without objective criteria. In the present study, pancreatic stiffness was quantified using intraoperative ultrasound elastography, and its relevance to POPF and histopathology was investigated. Forty-one patients (pancreatoduodenectomy, 30; distal pancreatectomy, 11) who underwent intraoperative elastography during pancreatectomy were included. The elastic ratio was determined at the pancreatic resection site (just above the portal vein) and at the remnant pancreas (head or tail). Correlations between the incidence of POPF and patient characteristics, operative variables, and the elastic ratio were examined. In addition, the relationship between the elastic ratio and the percentage of the exocrine gland at the resection stump was investigated. For pancreatoduodenectomy patients, main pancreatic duct diameter < 3.2 mm and elastic ratio < 2.09 were significant risk factors for POPF. In addition, the elastic ratio, but not main pancreatic duct diameter, was significantly associated with the percentage of exocrine gland area at the pancrea...Continue Reading

References

Jul 9, 2005·Surgery·Claudio BassiUNKNOWN International Study Group on Pancreatic Fistula Definition
Feb 18, 2006·Radiology·Ako ItohTakeshi Matsumura
Nov 23, 2006·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jordan M WinterCharles J Yeo
Nov 29, 2007·Annals of Surgery·Abhishek MathurKeith D Lillemoe
Oct 15, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Woo Seok KimDong Do You
Nov 16, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Nicolò PecorelliMarco Braga
Apr 11, 2012·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Hironori OchiMorikazu Onji

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Citations

May 25, 2016·Scandinavian Journal of Gastroenterology·Kjetil Søreide, Knut Jørgen Labori
Jul 18, 2019·Clinical Endoscopy·Christoph F Dietrich, Michael Hocke
Nov 1, 2017·World Journal of Gastrointestinal Endoscopy·Tanyaporn Chantarojanasiri, Pradermchai Kongkam
Apr 15, 2016·World Journal of Gastroenterology : WJG·Natsuko Kawada, Sachiko Tanaka
Oct 31, 2020·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Natascha Platz Batista da SilvaErnst Michael Jung
Aug 5, 2021·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Orhan SezginOsman Özdoğan

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