Evidence map›Paper›PMID 39818518›Full record

Trial reportHPB : the official journal of the International Hepato Pancreato Biliary Association2025

Postoperative pancreatic fistula risk assessment using digital pathology based analyses at the parenchymal resection margin of the pancreas - Results from the randomized multicenter RECOPANC trial.

Ambrus Màlyi, Peter Bronsert, Oliver Schilling, Kim C Honselmann, Louisa Bolm, Szilárd Szanyi, Zoltán Benyó, Martin Werner, Tobias Keck, Ulrich F Wellner and 2 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Ambrus MàlyiInstitute for Surgical Pathology, Medical Center - University of Freiburg, Germany; Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; Core Facility for Histopathology and Digital Pathology, University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany.
Peter BronsertInstitute for Surgical Pathology, Medical Center - University of Freiburg, Germany; Core Facility for Histopathology and Digital Pathology, University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany.
Oliver SchillingInstitute for Surgical Pathology, Medical Center - University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany; German Consortium for Translational Cancer Research (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.
Kim C HonselmannDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Louisa BolmDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Szilárd SzanyiInstitute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; Head and Neck Tumors Multidisciplinary Center and the National Tumor Biology Laboratory, National Institute of Oncology, Budapest, Hungary; Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Hungary.
Zoltán BenyóInstitute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary.
Martin WernerInstitute for Surgical Pathology, Medical Center - University of Freiburg, Germany; Core Facility for Histopathology and Digital Pathology, University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany; German Consortium for Translational Cancer Research (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.
Tobias KeckDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Ulrich F WellnerDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Sylvia TimmeInstitute for Surgical Pathology, Medical Center - University of Freiburg, Germany; Core Facility for Histopathology and Digital Pathology, University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany. Electronic address: Sylvia.timme@uniklinik-freiburg.de.
RECOPANC Study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn pancreatic surgery Postoperative pancreatic fistula (POPF) represents the most dreaded complication, for which pancreatic texture is acknowledged as one of the strongest predictors. No consensual objective reference has been defined to evaluate the pancreas composition. The presented study aimed to mine histology data of the pancreatic tissue composition with AI assist and correlate it with clinic-pathological parameters derived from the RECOPANC study.

methodFrom 320 patients originally included in the RECOPANC multicentric study, after series of exclusions slides of 134 patients were selected of AI-assisted analysis.For each slide tissue training fields were defined. Machine learning was trained to differentiate the tissue compartments: acinar, fibrotic, and adipose tissue, followed by quantification of the tissue area compartments.

resultsRelative fibrotic tissue area revealed as the strongest determinant for the prediction of clinically relevant POPF in multivariable analysis (p = 0.027). The AI assessed amount of fibrotic tissue performed significantly better in prediction of fistula development compared to the surgical palpatory assessment of the pancreatic texture.

conclusionThe present study is the first correlating AI-assisted quantified pancreatic tissue composition and POPF within a multicentric cohort.

Indexed as

Image Interpretation, Computer-AssistedMargins of ExcisionPancreasPancreatectomyPancreatic FistulaPancreatic NeoplasmsPostoperative ComplicationsAgedFemaleFibrosisHumansMachine LearningMaleMiddle AgedPredictive Value of TestsRisk Assessment

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.