Risk factors for pancreatic anastomotic leakage: the significance of preoperative dynamic magnetic resonance imaging of the pancreas as a predictor of leakage

Journal of the American College of Surgeons
Yoshitsugu TajimaTakashi Kanematsu

Abstract

The histologic degree of pancreatic fibrosis can be assessed preoperatively by using the time-signal intensity curve (TIC) of the pancreas obtained from dynamic magnetic resonance imaging. To identify risk factors for postoperative pancreatic anastomotic leakage and to assess the impact of pancreatic TIC on this complication, 89 patients who underwent a pancreatic head resection with an end-to-side pancreaticojejunostomy between December 1998 and August 2005 were retrospectively reviewed. The pancreatic TIC profiles were classified into 3 types: type I, indicating a normal pancreas without fibrosis; and types II and III indicating fibrotic pancreas. Pancreaticojejunal anastomotic leakage occurred in 14 patients (16%). In a univariate analysis, pancreatic texture (hard, 3% versus intermediate, 20% versus soft, 23%; p = 0.046), pancreatic duct size (> 3 mm, 8% versus <or= 3 mm, 25%; p = 0.037), and pancreatic TIC (types II, III, 3% versus type I, 25%; p = 0.006) were notably associated with pancreatic anastomotic leakage. In a multivariable analysis, pancreatic TIC (odds ratio [OR], 9.58; 95% CI, 1.1 to 91.7) was the only marked independent predictor of postoperative pancreatic leakage. A subanalysis of 52 patients with type I pa...Continue Reading

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Citations

Dec 6, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Dietmar J DinterMarco Niedergethmann
May 6, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Hiroyuki NakamuraTaijiro Sueda
Aug 27, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Motokazu SugimotoMasaru Konishi
Nov 19, 2010·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Ulrich Friedrich WellnerTobias Keck
Apr 28, 2009·The Journal of Surgical Research·Orlin BelyaevWaldemar Uhl
Sep 17, 2013·Journal of Clinical Laboratory Analysis·Hyun Wook ShinDong Sup Yoon
Dec 30, 2014·The Journal of Surgical Research·Motokazu SugimotoMasaru Konishi
Apr 26, 2014·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Tae Kil LeeMyeong-Jin Kim
May 18, 2011·The American Journal of Gastroenterology·Erwin J M van GeenenChris J J Mulder
Oct 12, 2018·ANZ Journal of Surgery·Savio G BarretoSanjay Pandanaboyana
Jun 19, 2019·World Journal of Gastroenterology : WJG·Ye LiJian Zhou
Nov 20, 2020·Khirurgiia·E S DrozdovS S Klokov
May 5, 2021·European Journal of Radiology·Stephan M SkawranCaecilia S Reiner
Jul 29, 2010·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Chris D MannDavid P Berry
Oct 18, 2007·Current Opinion in Endocrinology, Diabetes, and Obesity

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