ArticleBMC surgery2020
Pancreas-visceral fat CT value ratio and serrated pancreatic contour are strong predictors of postoperative pancreatic fistula after pancreaticojejunostomy.
Article in BMC surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- A Simple Classification of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery.Annals of surgery · 2023Pooled it
- Developing and validating a nomogram to forecast clinically relevant postoperative pancreatic fistula following distal pancreatectomy.Gland surgery · 2025Article
- Use of Histomorphological Features for the Prediction of Grade C Fistula after Whipple Procedure: A Difficult Task.Visceral medicine · 2025Article
- Correlation Between Fatty Pancreas Disease and Pancreatic Diseases, Perioperative Complications of Pancreatic Surgery.Cancer management and research · 2025Review
- Role of Pancreatic Attenuation Index in Assessing Pancreatic Fat Content and Postpancreatectomy Outcomes.The Indian journal of radiology & imaging · 2024Article
- Preoperative Fistula Risk Prediction Using Computed Tomography Image Before Pancreatoduodenectomy.Annals of surgical oncology · 2023Article
- Visual assessment of pancreatic fat deposition: useful grading system and the relation to BMI and diabetes.Japanese journal of radiology · 2023Article
- Development and external validation of DISPAIR fistula risk score for clinically relevant postoperative pancreatic fistula risk after distal pancreatectomy.The British journal of surgery · 2022Article
- Article
- A preserved pancreatic exocrine function after pancreatectomy may be a crucial cause of pancreatic fistula: paradoxical results of theSurgery today · 2022Article
- The usefulness of preoperative exocrine function evaluated by theBMC surgery · 2022Article
- Quantitative Assessment of Pancreatic Fat by Quantitative CT in Type 2 Diabetes Mellitus.International journal of general medicine · 2022Article
- Preoperative Computed Tomography Imaging of the Pancreas Identifying Predictive Factors for the Progression of Grade A, or Biochemical Leak, to Grade B Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy: A Retrospective Study.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
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16 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundOur aim is to elucidate the true preoperative risk factors for postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD), making it possible to select POPF high-risk patients preoperatively regardless of intraoperative pancreatic consistency judged by the surgeon's hand.
methodsAmong the 298 patients who underwent PD with pancreaticojejunostomy from 2007 to 2016, 262 patients had preoperative CT configurations that could be precisely evaluated. Risk factor analyses were conducted using various perioperative factors, including preoperative CT findings, such as CT values of the pancreas, pancreas-visceral fat CT value ratio and pancreatic outer contour. Pancreatic outer contour was further divided into smooth- (smooth interlobular) and serrated-type contours (feathery, irregular interlobular) by preoperative CT.
resultsIn terms of the incidence of POPF, among the 262 patients, POPF grade B/C was found in 27 (10.3%): grade B in 23 (8.8%) and grade C in 4 (1.5%). According to multivariate analysis, a high pancreas-visceral fat CT value ratio (p = 0.002), serrated-type contour (p = 0.02) and no history of chemoradiotherapy (p = 0.019) were identified as independent risk factors for POPF grade B/C. Even in patients with soft pancreas, the incidence of POPF grade B/C was 0% (0/57) in patients with a pancreas-visceral fat CT value ratio of less than - 0.4 and smooth-type contour, whereas the incidence was markedly high (45.0%, 9/20) in patients with a pancreas-visceral fat CT value ratio of - 0.4 or greater and serrated-type contour, indicating that patients with soft pancreas should be categorized into POPF high-risk and low-risk groups according to preoperative CT scan results.
conclusionsThe pancreas-visceral fat CT value ratio and serrated-type pancreas are useful markers to preoperatively identify true POPF high-risk groups in patients undergoing PD, regardless of the pancreatic texture judged intraoperatively.
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