Body Mass Index and Stump Morphology Predict an Increased Incidence of Pancreatic Fistula After Pancreaticoduodenectomy
Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and a...
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| Autor*in: |
Fang, Chi-hua [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2016 |
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| Schlagwörter: |
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| Anmerkung: |
© Société Internationale de Chirurgie 2016 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 40(2016), 6 vom: 21. Jan., Seite 1467-1476 |
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| Übergeordnetes Werk: |
volume:40 ; year:2016 ; number:6 ; day:21 ; month:01 ; pages:1467-1476 |
| Links: |
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| DOI / URN: |
10.1007/s00268-016-3413-5 |
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SPR003457338 |
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| 520 | |a Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. MI-3DVS provides us a novel and convenient method for measuring the RPPV. Preoperative acquisition of RPPV and BMI may help the surgeons in fitting postoperative management to patient’s individual risk after PD. | ||
| 650 | 4 | |a Pancreatic Fistula |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Main Pancreatic Duct |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Compute Tomographic Data |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Xiang, Fei |4 aut | |
| 700 | 1 | |a Fang, Zhao-shan |4 aut | |
| 700 | 1 | |a Zhu, Wen |4 aut | |
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10.1007/s00268-016-3413-5 doi (DE-627)SPR003457338 (SPR)s00268-016-3413-5-e DE-627 ger DE-627 rakwb eng Fang, Chi-hua verfasserin aut Body Mass Index and Stump Morphology Predict an Increased Incidence of Pancreatic Fistula After Pancreaticoduodenectomy 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. MI-3DVS provides us a novel and convenient method for measuring the RPPV. Preoperative acquisition of RPPV and BMI may help the surgeons in fitting postoperative management to patient’s individual risk after PD. Pancreatic Fistula (dpeaa)DE-He213 Main Pancreatic Duct (dpeaa)DE-He213 Compute Tomographic Data (dpeaa)DE-He213 Pancreatic Stump (dpeaa)DE-He213 Postoperative Pancreatic Fistula (dpeaa)DE-He213 Chen, Qing-shan aut Yang, Jian aut Xiang, Fei aut Fang, Zhao-shan aut Zhu, Wen aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 6 vom: 21. Jan., Seite 1467-1476 (DE-627)SPR003391159 nnns volume:40 year:2016 number:6 day:21 month:01 pages:1467-1476 https://dx.doi.org/10.1007/s00268-016-3413-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 6 21 01 1467-1476 |
| spelling |
10.1007/s00268-016-3413-5 doi (DE-627)SPR003457338 (SPR)s00268-016-3413-5-e DE-627 ger DE-627 rakwb eng Fang, Chi-hua verfasserin aut Body Mass Index and Stump Morphology Predict an Increased Incidence of Pancreatic Fistula After Pancreaticoduodenectomy 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. MI-3DVS provides us a novel and convenient method for measuring the RPPV. Preoperative acquisition of RPPV and BMI may help the surgeons in fitting postoperative management to patient’s individual risk after PD. Pancreatic Fistula (dpeaa)DE-He213 Main Pancreatic Duct (dpeaa)DE-He213 Compute Tomographic Data (dpeaa)DE-He213 Pancreatic Stump (dpeaa)DE-He213 Postoperative Pancreatic Fistula (dpeaa)DE-He213 Chen, Qing-shan aut Yang, Jian aut Xiang, Fei aut Fang, Zhao-shan aut Zhu, Wen aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 6 vom: 21. Jan., Seite 1467-1476 (DE-627)SPR003391159 nnns volume:40 year:2016 number:6 day:21 month:01 pages:1467-1476 https://dx.doi.org/10.1007/s00268-016-3413-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 6 21 01 1467-1476 |
| allfields_unstemmed |
10.1007/s00268-016-3413-5 doi (DE-627)SPR003457338 (SPR)s00268-016-3413-5-e DE-627 ger DE-627 rakwb eng Fang, Chi-hua verfasserin aut Body Mass Index and Stump Morphology Predict an Increased Incidence of Pancreatic Fistula After Pancreaticoduodenectomy 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. MI-3DVS provides us a novel and convenient method for measuring the RPPV. Preoperative acquisition of RPPV and BMI may help the surgeons in fitting postoperative management to patient’s individual risk after PD. Pancreatic Fistula (dpeaa)DE-He213 Main Pancreatic Duct (dpeaa)DE-He213 Compute Tomographic Data (dpeaa)DE-He213 Pancreatic Stump (dpeaa)DE-He213 Postoperative Pancreatic Fistula (dpeaa)DE-He213 Chen, Qing-shan aut Yang, Jian aut Xiang, Fei aut Fang, Zhao-shan aut Zhu, Wen aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 6 vom: 21. Jan., Seite 1467-1476 (DE-627)SPR003391159 nnns volume:40 year:2016 number:6 day:21 month:01 pages:1467-1476 https://dx.doi.org/10.1007/s00268-016-3413-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 6 21 01 1467-1476 |
| allfieldsGer |
10.1007/s00268-016-3413-5 doi (DE-627)SPR003457338 (SPR)s00268-016-3413-5-e DE-627 ger DE-627 rakwb eng Fang, Chi-hua verfasserin aut Body Mass Index and Stump Morphology Predict an Increased Incidence of Pancreatic Fistula After Pancreaticoduodenectomy 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. MI-3DVS provides us a novel and convenient method for measuring the RPPV. Preoperative acquisition of RPPV and BMI may help the surgeons in fitting postoperative management to patient’s individual risk after PD. Pancreatic Fistula (dpeaa)DE-He213 Main Pancreatic Duct (dpeaa)DE-He213 Compute Tomographic Data (dpeaa)DE-He213 Pancreatic Stump (dpeaa)DE-He213 Postoperative Pancreatic Fistula (dpeaa)DE-He213 Chen, Qing-shan aut Yang, Jian aut Xiang, Fei aut Fang, Zhao-shan aut Zhu, Wen aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 6 vom: 21. Jan., Seite 1467-1476 (DE-627)SPR003391159 nnns volume:40 year:2016 number:6 day:21 month:01 pages:1467-1476 https://dx.doi.org/10.1007/s00268-016-3413-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 6 21 01 1467-1476 |
| allfieldsSound |
10.1007/s00268-016-3413-5 doi (DE-627)SPR003457338 (SPR)s00268-016-3413-5-e DE-627 ger DE-627 rakwb eng Fang, Chi-hua verfasserin aut Body Mass Index and Stump Morphology Predict an Increased Incidence of Pancreatic Fistula After Pancreaticoduodenectomy 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2016 Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. MI-3DVS provides us a novel and convenient method for measuring the RPPV. Preoperative acquisition of RPPV and BMI may help the surgeons in fitting postoperative management to patient’s individual risk after PD. Pancreatic Fistula (dpeaa)DE-He213 Main Pancreatic Duct (dpeaa)DE-He213 Compute Tomographic Data (dpeaa)DE-He213 Pancreatic Stump (dpeaa)DE-He213 Postoperative Pancreatic Fistula (dpeaa)DE-He213 Chen, Qing-shan aut Yang, Jian aut Xiang, Fei aut Fang, Zhao-shan aut Zhu, Wen aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 40(2016), 6 vom: 21. Jan., Seite 1467-1476 (DE-627)SPR003391159 nnns volume:40 year:2016 number:6 day:21 month:01 pages:1467-1476 https://dx.doi.org/10.1007/s00268-016-3413-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 40 2016 6 21 01 1467-1476 |
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There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. 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body mass index and stump morphology predict an increased incidence of pancreatic fistula after pancreaticoduodenectomy |
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Body Mass Index and Stump Morphology Predict an Increased Incidence of Pancreatic Fistula After Pancreaticoduodenectomy |
| abstract |
Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. MI-3DVS provides us a novel and convenient method for measuring the RPPV. Preoperative acquisition of RPPV and BMI may help the surgeons in fitting postoperative management to patient’s individual risk after PD. © Société Internationale de Chirurgie 2016 |
| abstractGer |
Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. MI-3DVS provides us a novel and convenient method for measuring the RPPV. Preoperative acquisition of RPPV and BMI may help the surgeons in fitting postoperative management to patient’s individual risk after PD. © Société Internationale de Chirurgie 2016 |
| abstract_unstemmed |
Background A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. Method A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included. Preoperative computed tomographic (CT) images were imported into the Medical Image Three-Dimensional Visualization System (MI-3DVS) for acquiring the morphological features of pancreatic stump. The demographics, laboratory test and morphological features of pancreatic stump were recorded prospectively. The clinical course was evaluated focusing on the occurrence of pancreatic fistula as defined by the International Study Group on Pancreatic Fistula (ISGPF). Logistic regression analysis was used to identify independent predictors of CR-POPF. Results CR-POPF occurred in 18 patients (14 grade B, 4 grade C). In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. MI-3DVS provides us a novel and convenient method for measuring the RPPV. Preoperative acquisition of RPPV and BMI may help the surgeons in fitting postoperative management to patient’s individual risk after PD. © Société Internationale de Chirurgie 2016 |
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In univariate analysis, male gender (P = 0.026), body mass index (BMI) ≥ 25.3 kg/$ m^{2} $ (P = 0.002), main pancreas duct diameter (MPDD) < 3.1 mm (P = 0.005), remnant pancreatic parenchymal volume (RPPV) > 27.8 mL (P < 0.001), and area of cut surface (AOCS) > 222.3 $ mm^{2} $ (P < 0.001) were associated with an increased risk of CR-POPF. In multivariate analysis, BMI ≥ 25.3 kg/$ m^{2} $ (OR 12.238, 95 % CI 1.822–82.215, P = 0.010) and RPPV > 27.8 mL (OR 12.907, 95 % CI 1.602–104.004, P = 0.016) were the only independent risk factors associated with CR-POPF. A cut-off value of 27.8 mL for RPPV established based on the receiver operating characteristic (ROC) curve, which was the strongest single predictive factor for CR-POPF, with a sensitivity and specificity of 77.8 and 86.1 %, respectively. The area under the ROC curve of RPPV was 0.770 (95 % CI 0.629–0.911, P < 0.001). Conclusions Our study demonstrated that CR-POPF is correlated with BMI and RRPV. 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