Prediction of Postoperative Pancreatic Fistula Occurrence by the Pancreatic Stump Shape and Remnant Pancreatic Volume Measured Using AI-Guided Three-Dimensional Simulation.

Ryoichi Miyamoto, Masahiro Shiihara, Mitsuru Watanabe, Jiro Shimazaki, Mitsugi Shimoda, Shuji Suzuki

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Ryoichi MiyamotoDepartment of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan. goodfirst883@gmail.com.ORCID http://orcid.org/0000-0003-0687-6225

Masahiro ShiiharaDepartment of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan.

Mitsuru WatanabeDepartment of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan.

Jiro ShimazakiDepartment of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan.

Mitsugi ShimodaDepartment of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan.

Shuji SuzukiDepartment of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan.

Funding

Grant-in-Aid for Scientific Research (KAKENHI, 23K19551) from The Ministry of Education, Culture, Sports, Science, and Technology of Japan. 23K19551

6 · The paper itself

Abstract

backgroundWhen three-dimensional computer graphics (3DCG) images are used, artificial intelligence (AI) engines can semiautomatically estimate the pancreatic thickness, pancreatic stump shape (PSS), surface area of the resected pancreatic stump, and remnant pancreatic volume (RPV). Here, we report the potential applications of the PSS and RPV and investigate postoperative pancreatic fistula (POPF) risk factors. PATIENTS AND

methodsWe included 109 patients with pancreatic cancer in this study. First, we employed the roundness value to objectively evaluate the PSS. The correlations between the roundness value and the pancreatic thickness and surface area of the resected pancreatic stump were examined. In terms of RPV evaluation, we employed the RPV ratio, which was automatically calculated by the software by dividing the volume of the remnant pancreas by the total volume of the pancreas. Second, we performed a multivariable analysis to identify POPF risk factors, including the roundness value and RPV ratio.

resultsThe roundness value was significantly correlated with the pancreatic thickness and surface area of the resected pancreatic stump. Multivariable logistic regression analysis also revealed that a roundness value ≤ 11.3, an RPV ratio > 0.65, the absence of pathological fibrosis, and a pancreatic duct diameter ≤ 2.0 mm were independent risk factors for POPF.

conclusionsThe preoperative roundness value and RPV ratio measured from 3DCG images were able to predict POPF occurrence.

Indexed as

Artificial IntelligenceComputer SimulationImaging, Three-DimensionalPancreasPancreatectomyPancreatic FistulaPancreatic NeoplasmsPostoperative ComplicationsAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedOrgan SizePrognosisAIDeep learning algorithmPancreatic fistulaPancreatic surgeryPancreatic volume

Identifiers

PMID41723320

DOI10.1016/j.jamcollsurg.2012.09.002

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