Experimental and Health Sciences Department, Universitat Pompeu Fabra, Barcelona, Spain.
School of Medicine, Universitat Pompeu Fabra and UAB, Barcelona, Spain.
Sci Rep. 2019 Oct 10;9(1):14517. doi: 10.1038/s41598-019-51173-1.
The aim of this retrospective study was thus to evaluate postoperative morphological changes in the remnant pancreas after pancreaticoduodenectomy (PD) associated with postoperative pancreatic fistula (POPF). Fifty-one patients subjected to PD were enrolled in the study and allocated into 2 groups according to the presence (n = 16) or absence of POPF (n = 35). A morphological evaluation of the pancreas was conducted for up to a 20 months follow-up on CT scans and compared between groups. No significant differences were observed in morphology between the groups at the different preoperative and PO intervals, regardless of the clinical relevance of the POPF or POPF grade. However, in the overall patient analysis we observed a significant reduction of the entire pancreas over time. In fact, thickness decreased 0.4 mm/month, length 1.2 mm/month and volume 1.17 cm/month over the PO. The impact of age, POPF, type of anastomosis, surgical technique and PO follow-up (time) was evaluated in a multivariate analysis using the general linear model, but only PO follow-up had a significant influence on the final model (p < 0.001). A significant reduction on pancreatic parenchyma (thickness, length and volume) occurs after PD with no significant differences between patients with or without POPF.
本回顾性研究旨在评估胰十二指肠切除术（PD）后与术后胰瘘（POPF）相关的残胰形态学变化。本研究纳入了 51 例接受 PD 的患者，并根据是否存在 POPF（n=16）或不存在 POPF（n=35）将其分为两组。在 CT 扫描上进行了长达 20 个月的随访，对胰腺的形态进行了评估，并在两组之间进行了比较。无论 POPF 或 POPF 分级的临床意义如何，两组在不同的术前和 PO 间隔的形态均无显著差异。然而，在总体患者分析中，我们观察到整个胰腺随时间的显著减少。事实上，厚度每月减少 0.4mm，长度每月减少 1.2mm，体积每月减少 1.17cm。使用一般线性模型对年龄、POPF、吻合类型、手术技术和 PO 随访（时间）的影响进行了多变量分析，但只有 PO 随访对最终模型有显著影响（p<0.001）。PD 后胰腺实质（厚度、长度和体积）明显减少，但存在或不存在 POPF 的患者之间无显著差异。
