Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
HPB (Oxford). 2020 Jan;22(1):67-74. doi: 10.1016/j.hpb.2019.05.008. Epub 2019 Jun 19.
Some parameters using preoperative computed tomography (CT) have been evaluated to predict the development of pancreatic fistula (PF) after pancreaticoduodenectomy (PD). The present retrospective study evaluated the predictive value of pancreatic attenuation for PF after PD.
A retrospective review was conducted of the patients who underwent PD between January 2010 and December 2014. The pancreatic attenuation was measured in unenhanced preoperative CT images. Pre- and intraoperative variables were analyzed for the risk of PF after PD.
Of the 346 consecutive patients, PF occurred in 116 (34%). The pancreatic attenuation was significantly greater in patients with PF than in those without PF (median, 40.0 vs. 33.3 Hounsfield units [HU], P < 0.001). A multivariate analysis showed that a pancreatic attenuation ≥30.0 HU (odds ratio [OR], 3.72; P < 0.001), a body mass index ≥25.0 kg/m (OR, 3.67; P < 0.001) and a diameter of the main pancreatic duct <3.0 mm (OR, 1.84; P = 0.034) were independent risk factors for PF after PD.
The degree of pancreatic attenuation on preoperative CT images was significantly associated with PF, and a pancreatic attenuation ≥30.0 HU was an independent risk factor of PF after PD.
一些使用术前计算机断层扫描（CT）的参数已被评估用于预测胰十二指肠切除术后（PD）胰瘘（PF）的发生。本回顾性研究评估了 PD 后胰腺衰减对 PF 的预测价值。
回顾性分析了 2010 年 1 月至 2014 年 12 月期间接受 PD 的患者。在未增强的术前 CT 图像中测量胰腺衰减。分析了术前和术中变量与 PD 后 PF 的风险。
346 例连续患者中，116 例（34%）发生 PF。PF 患者的胰腺衰减明显大于无 PF 患者（中位数，40.0 与 33.3 亨氏单位[HU]，P < 0.001）。多变量分析显示，胰腺衰减≥30.0 HU（比值比[OR]，3.72；P < 0.001）、体质指数≥25.0 kg/m（OR，3.67；P < 0.001）和主胰管直径<3.0 mm（OR，1.84；P = 0.034）是 PD 后 PF 的独立危险因素。
术前 CT 图像上的胰腺衰减程度与 PF 显著相关，胰腺衰减≥30.0 HU 是 PD 后 PF 的独立危险因素。
