A Novel Radiological Predictor for Postoperative Pancreatic Fistula After Stapled Distal Pancreatectomy
Yusuf Murat Bag1, Cagdas Topel2, Egemen Ozdemir1
1Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey.
Background:
Distal pancreatectomy (DP) is the main surgical treatment of benign and malignant lesions located in pancreatic body and tail. Postoperative pancreatic fistula (POPF) following DP is still a considerable cause of morbidity. Identification of risk factors for POPF after DP might provide some preventive applications. We aimed to evaluate the factors affecting POPF after DP and to present a new and easy radiological predictive factor.
Materials And Methods:
Thirty-four patients underwent DP with stapler closure were included. Several risk factors for clinically relevant POPF (CR-POPF) were analyzed. Additionally, computed tomography findings of pancreatic thickness (PT), main pancreatic duct diameter (MPDD), and PT/MPDD ratio were evaluated for POPF.
Results:
CR-POPF was observed in 10 patients (29.4%). Univariate and multivariate analyses showed that previous abdominal surgery and PT/MPDD ratio were predictive factors for CR-POPF after DP (P = 0.040, P = 0.034, respectively). The cutoff value for the PT/MPDD ratio was 8.
Conclusion:
A PT/MPDD ratio greater than 8 (a wide pancreas with a narrow duct) is a significant predictive factor for CR-POPF following DP.
