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Computer tomographic assessment of postoperative peripancreatic collections after distal pancreatectomy

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Abstract

Background

Peripancreatic collections occur frequently after distal pancreatectomy. However, the sequelae of peripancreatic collections vary from case to case, and their clinical impact is uncertain. In this study, the correlations between CT findings of peripancreatic collections and complications after distal pancreatectomy were investigated.

Methods

Ninety-six consecutive patients who had undergone distal pancreatectomy between 2010 and 2015 were retrospectively investigated. The extent and heterogeneity of peripancreatic collections and background clinicopathological characteristics were analyzed. The extent of peripancreatic collections was calculated based on three-dimensional computed tomography images, and the degree of heterogeneity of peripancreatic collections was assessed based on the standard deviation of their density on computed tomography.

Results

Of 85 patients who underwent postoperative computed tomography imaging, a peripancreatic collection was detected in 77 (91%). Patients with either a large extent or a high degree of heterogeneity of peripancreatic collection had a significantly higher rate of clinically relevant pancreatic fistula than those without (odds ratio 5.95, 95% confidence interval 2.12–19.72, p = 0.001; odds ratio 8.0, 95% confidence interval 2.87–24.19, p = 0.0001, respectively).

Conclusions

A large and heterogeneous peripancreatic collection was significantly associated with postoperative complications, especially clinically relevant postoperative pancreatic fistula. A small and homogenous peripancreatic collection could be safely observed.

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Authors and Affiliations

  1. Division of Hepatobiliary Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, Syogoinkawaharacho 54, Sakyo-ku, Kyoto, Japan

    Yuichiro Uchida, Toshihiko Masui, Asahi Sato, Kazuyuki Nagai, Takayuki Anazawa, Kyoichi Takaori & Shinji Uemoto

Authors
  1. Yuichiro Uchida
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  2. Toshihiko Masui
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  3. Asahi Sato
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  4. Kazuyuki Nagai
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  5. Takayuki Anazawa
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  6. Kyoichi Takaori
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  7. Shinji Uemoto
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Contributions

Study conception and design: Yuichiro Uchida, Toshihiko Masui, Shinji Uemoto. Acquisition of data: Yuichiro Uchida, Asahi Sato, Kazuyuki Nagai, Takayuki Anazawa. Analysis and interpretation of data: Yuichiro Uchida. Drafting of the manuscript: Yuichiro Uchida and Toshihiko Masui. Critical revision of the manuscript: Kyoichi Takaori.

Corresponding author

Correspondence to Toshihiko Masui.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Uchida, Y., Masui, T., Sato, A. et al. Computer tomographic assessment of postoperative peripancreatic collections after distal pancreatectomy. Langenbecks Arch Surg 403, 349–357 (2018). https://doi.org/10.1007/s00423-018-1668-z

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  • DOI: https://doi.org/10.1007/s00423-018-1668-z

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