Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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The effect of atrophied pancreas as shown in the preoperative imaging on the leakage rate after pancreaticoduodenectomy

  • Ashraf Imam (Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem) ;
  • Harbi Khalayleh (Department of Surgery, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem) ;
  • Meni Brakha (Department of Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University) ;
  • Ariel A. Benson (Department of Gastroenterology and Liver Diseases, Hadassah Medical Center) ;
  • Naama Lev-Cohain (Department of Radiology and Medical Imaging, Hadassah-Hebrew University Medical Center) ;
  • Gidon Zamir (Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem) ;
  • Abed Khalaileh (Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem)
  • Received : 2021.10.19
  • Accepted : 2021.12.13
  • Published : 2022.05.31
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Abstract

Backgrounds/Aims: The soft texture of the pancreas parenchyma may influence the incidence of pancreatic leakage after pancreaticcoduodenectomy (PD). One possible method to assess pancreatic texture and atrophy, is via computed tomography (CT) scan of the abdomen. The purpose of our study was to evaluate the relation between the preoperative CT scan and the incidence of pancreatic fistula after PD. Methods: A retrospective single-center study including patients who underwent PD for a benign and malignant tumor of the periampullary region between the years 2000 and 2016. Demographic and imaging data were analysed and a correlation with the post-operative leak was evaluated. Results: Pancreatic leak was documented in 34 out of 154 (22.1%) patients. All the leakage cases occurred in the preserved pancreas group (33.1% of the total preserved pancreas group alone). No leak was documented in the atrophic pancreas group. This difference between the two groups was found to be statistically significant (p ≤ 0.00001). Conclusions: Atrophic pancreas in the preoperative CT scan may be protective against leakage after PD. These findings may help the surgeon to risk stratify patients accordingly. In addition, the findings suggest that patients with a preserved pancreas may require more protective methods to prevent leakage.

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References

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