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Prevent Pancreatic Fistula after Pancreatoduodenectomy: Possible Role of Ultrasound Elastography.
- Source :
-
Digestive surgery [Dig Surg] 2018; Vol. 35 (2), pp. 164-170. Date of Electronic Publication: 2017 Jun 01. - Publication Year :
- 2018
-
Abstract
- Background: The purpose of the study is to evaluate the utility of acoustic radiation force impulse (ARFI) on pancreatic tissue as a preoperative predictor of postoperative pancreatic fistula (POPF). Studied patients underwent exclusively to pancreaticoduodenectomy (PD) surgery.<br />Methods: Shear wave velocity of pancreas was measured using ARFI in 71 patients scheduled for PD. An intraoperative pancreas palpation was made by surgeons. A postoperative clinical evaluation to detect occurrence of POPF was performed. Sensitivity, specificity, positive and negative predictive values together with the accuracy of the method were investigated.<br />Results: Incidence of fistula observed in 17 patients with soft pancreas was approximately 53% vs. 47% without fistula. Percentage of patients without fistula was higher (66%) among 24 patients with medium parenchymal texture values, and was even higher (69%) in 26 patients with hard pancreas. Comparing ARFI and intraoperative pancreatic palpation, low wave velocity values (≤1.40 m/s) match 60% with soft parenchyma assessed by palpation and high values (>2 m/s) match 59% with hard pancreas on palpation.<br />Conclusions: This study shows that ARFI elastography may be clinically useful as a preoperative predictor of pancreatic fistula following PD.<br /> (© 2017 S. Karger AG, Basel.)
- Subjects :
- Adult
Aged
Cohort Studies
Female
Follow-Up Studies
Hospitals, University
Humans
Italy
Male
Middle Aged
Monitoring, Intraoperative methods
Pancreatic Fistula etiology
Pancreaticoduodenectomy methods
Predictive Value of Tests
Preoperative Care methods
Retrospective Studies
Risk Assessment
Treatment Outcome
Elasticity Imaging Techniques methods
Pancreatic Fistula prevention & control
Pancreatic Neoplasms diagnostic imaging
Pancreatic Neoplasms surgery
Pancreaticoduodenectomy adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9883
- Volume :
- 35
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Digestive surgery
- Publication Type :
- Academic Journal
- Accession number :
- 28564643
- Full Text :
- https://doi.org/10.1159/000477475