1. Prediction of Post-Gastrectomy Pancreatic Complications: A Preoperative Imaging Study Based on Computed Tomography.
- Author
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Ohi M, Toiyama Y, Yasuda H, Ichikawa T, Uratani R, Kitajima T, Shimura T, Imaoka H, Kawamura M, Morimoto Y, Okugawa Y, Okita Y, and Yoshiyama S
- Subjects
- Humans, Male, Female, Retrospective Studies, Middle Aged, Aged, Laparoscopy adverse effects, Adult, Preoperative Care methods, Predictive Value of Tests, Incidence, Hepatic Artery diagnostic imaging, Risk Factors, Pancreatic Diseases surgery, Pancreatic Diseases diagnostic imaging, Gastrectomy adverse effects, Tomography, X-Ray Computed, Postoperative Complications diagnostic imaging, Postoperative Complications epidemiology, Postoperative Complications etiology, Pancreas diagnostic imaging, Stomach Neoplasms surgery, Stomach Neoplasms diagnostic imaging
- Abstract
Background: Postoperative pancreas-related complications (PPRCs) are common after laparoscopic gastrectomy (LG) in patients with gastric cancer. We estimated the anatomical location of the pancreas on a computed tomography (CT) image and investigated its impact on the incidence of PPRCs after LG., Methods: We retrospectively reviewed the preoperative CT images of 203 patients who underwent LG for gastric cancer between January 2010 and December 2017. From these images, we measured the gap between the upper edge of the pancreatic body and the root of the common hepatic artery. We evaluated the potential relationship between PPRCs and the gap between pancreas and common hepatic artery (GPC) status using an analysis based on the median cutoff value and assessed the impact of GPC status on PPRC incidence. We performed univariate and multivariate analyses to identify predictive factors for PPRC., Result: Postoperative pancreas-related complications occurred in 11 patients (5.4%). The median of the optimal cutoff GPC value for predicting PPRC was 0 mm; therefore, we classified the GPC status into two groups: GPC plus group and GPC minus group. Univariate analysis revealed that sex (male), C-reactive protein (CRP) > .07 mg/dl, GPC plus, and visceral fat area (VFA) > 99 cm
2 were associated with the development of PPRC. Multivariate analysis identified only GPC plus as independent predictor of PPRC (hazard ratio: 4.60 [95% confidence interval 1.11-31.15], P = .034)., Conclusion: The GPC is a simple and reliable predictor of PPRC after LG. Surgeons should evaluate GPC status on preoperative CT images before proceeding with laparoscopic gastric cancer surgery., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.- Published
- 2024
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