术前胰腺影像学密度在预测胰腺神经内分泌肿瘤手术后胰瘘中的意义
Significance of preoperative radiographic pancreatic density in predicting pancreatic fistula after surgery for pancreatic neuroendocrine tumors.
作者信息
Assadipour Yasmine, Azoury Saïd C, Schaub Nicholas N, Hong Young, Eil Robert, Inchauste Suzanne M, Steinberg Seth M, Venkatesan Aradhana M, Libutti Steven K, Hughes Marybeth S
机构信息
Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD.
Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD; Thoracic and Gastrointestinal Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD.
出版信息
Am J Surg. 2016 Jul;212(1):40-6. doi: 10.1016/j.amjsurg.2015.07.031. Epub 2015 Dec 12.
BACKGROUND
Postoperative pancreatic fistula remains the most severe and worrisome complication after surgery. Predictive preoperative assessment remains challenging. The authors examine the role of pancreatic computed tomography density in predicting postoperative pancreatic fistula after surgery for pancreatic neuroendocrine tumors.
METHODS
A single institutional retrospective review of pancreatic surgery for neuroendocrine tumors between 1998 and 2010 was conducted. Preoperative contrast-enhanced computed tomography scans were reviewed, with mean region of interest measurements of pancreatic parenchymal density obtained from 10-mm thick axial computed tomography images.
RESULTS
A total of 119 patients were identified: 59 with enucleations and 60 with resections. Decreased preoperative pancreatic density was significantly associated with an increased grade of postoperative pancreatic fistula (P < .01). Subgroup analyses revealed that decreased gland density was associated with increased grade of postoperative pancreatic fistula in the resection (P < .01) but not in the enucleation group (P = .34).
CONCLUSIONS
A significant association between postoperative pancreatic fistula grade and preoperative pancreatic computed tomography density is observed in patients undergoing resection for pancreatic neuroendocrine tumors.
背景
术后胰瘘仍然是手术后最严重且令人担忧的并发症。术前预测性评估仍然具有挑战性。作者研究了胰腺计算机断层扫描密度在预测胰腺神经内分泌肿瘤手术后胰瘘中的作用。
方法
对1998年至2010年间行胰腺神经内分泌肿瘤手术的患者进行单机构回顾性研究。回顾术前增强计算机断层扫描，从10毫米厚的轴向计算机断层扫描图像中获取胰腺实质密度的平均感兴趣区域测量值。
结果
共纳入119例患者：59例行摘除术，60例行切除术。术前胰腺密度降低与术后胰瘘分级增加显著相关（P <.01）。亚组分析显示，腺体密度降低与切除术后胰瘘分级增加相关（P <.01），但在摘除术组中无相关性（P =.34）。
结论
在接受胰腺神经内分泌肿瘤切除术的患者中，观察到术后胰瘘分级与术前胰腺计算机断层扫描密度之间存在显著关联。
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