术前通过实时组织弹性成像评估胰腺硬度以预测胰十二指肠切除术后胰瘘的发生
Preoperative Pancreatic Stiffness by Real-time Tissue Elastography to Predict Pancreatic Fistula After Pancreaticoduodenectomy.
作者信息
Harada Noboru, Yoshizumi Tomoharu, Maeda Takashi, Kayashima Hiroto, Ikegami Toru, Harimoto Norifumi, Itoh Shinji, Maehara Yoshihiko
机构信息
Department of Surgery and Medical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Department of Surgery and Medical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
Anticancer Res. 2017 Apr;37(4):1909-1915. doi: 10.21873/anticanres.11529.
AIM
To assess the correlations among pancreatic fibrosis, pancreatic stiffness, and postoperative pancreatic fistula (PF).
PATIENTS AND METHODS
The study population consisted of 17 consecutively enrolled patients who underwent subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). The liver fibrosis (LF) index as pancreatic stiffness was measured by real-time tissue elastography (RTE) before SSPPD. We also obtained the pathological fibrosis assessment of the pancreatic stump after SSPPD.
RESULTS
The LF index was significantly correlated with pathological pancreatic stump fibrosis. The LF index of patients without PF was significantly higher than that of patients with PF. The optimal cut-off value of the LF index to predict postoperative PF was defined as an LF index ≤1.91. Multivariate analysis revealed that a preoperative LF index ≤1.91 was an independent predictive factor of postoperative PF.
CONCLUSION
Evaluation of pancreatic stiffness using RTE might be an objective index to estimate pancreatic fibrosis and predict postoperative PF.
目的
评估胰腺纤维化、胰腺硬度与术后胰瘘（PF）之间的相关性。
患者与方法
研究对象为17例连续入选的接受保留幽门的胰十二指肠次全切除术（SSPPD）的患者。在SSPPD术前，通过实时组织弹性成像（RTE）测量作为胰腺硬度的肝纤维化（LF）指数。我们还获得了SSPPD术后胰残端的病理纤维化评估结果。
结果
LF指数与胰残端病理纤维化显著相关。无PF患者的LF指数显著高于有PF患者。预测术后PF的LF指数最佳截断值定义为LF指数≤1.91。多因素分析显示，术前LF指数≤1.91是术后PF的独立预测因素。
结论
使用RTE评估胰腺硬度可能是估计胰腺纤维化和预测术后PF的客观指标。
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