Abstract:
BACKGROUND:Postoperative pancreatic fistula is a relevant complication after pancreatoduodenectomy. Therefore, preoperative detection of high risk patients may be important. We evaluated preoperative CT-imaging by planimetry at the expected resection plane along the superior mesenteric vein and correlated the results with the incidence of postoperative pancreatic fistula. PATIENTS AND METHODS:From 2009 to 2013, 123 patients with pancreatoduodenectomy underwent homogenous preoperative imaging and reconstruction of the pancreatojejunostomy. Planimetry was performed at a multiplanar reconstruction of the pancreatic transection plane (diameter, range, duct width, area) as well as the calculation of ratios (duct width/pancreatic diameter; D/P-ratio). The measured values were correlated with the incidence of postoperative pancreatic fistula. RESULTS:Planimetry showed a significant difference of the pancreatic transection plane in relation to the incidence of postoperative pancreatic fistula. A thick parenchyma and a tiny duct are significant risk factors. In 84 % or, respectively, 94 % of the patients with postoperative pancreatic fistula, a duct width of less than 20 % of the pancreatic diameter was observed (D/P ratio < 0.2; p < 0.01). The D/P ratio was the only independent risk factor in multivariate analysis. DISCUSSION:The incidence of postoperative pancreatic fistula correlates significantly with the morphology of the pancreatic transection plane. The risk increases significantly with a D/P ratio of < 0.2.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Riediger H,Krueger CM,Makowiec F,Adam U,Krüger Kdoi
10.1055/s-0035-1546193subject
Has Abstractpub_date
2016-08-01 00:00:00pages
446-53issue
4eissn
0044-409Xissn
1438-9592journal_volume
141pub_type
杂志文章abstract::By introduction of laparoscopic cholecystectomy, an increase of accidental common bile duct injuries up to 1.2% has been reported. In the present study of 325 cholecystectomies we evaluated whether mandatory intraoperative cholangiography (IOC) can reduce the rate of accidental bile duct injuries or, at least, identif...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1998-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
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更新日期:1998-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
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更新日期:1982-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
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更新日期:1997-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
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更新日期:1994-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
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journal_title:Zentralblatt fur Chirurgie
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更新日期:1997-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
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