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- Title
Multidetector CT findings differ between surgical grades of pancreatic fistula after pancreaticoduodenectomy.
- Authors
Lee, Hyo-jae; Kim, Jin Woong; Hur, Young Hoe; Lee, Byung Kook; Cho, Sung Bum; Hwang, Eu Chang; Lee, Seung Jin; Yoon, Eun Ju; Seon, Hyun Ju
- Abstract
<bold>Objectives: </bold>To define and correlate multidetector CT (MDCT) findings of pancreatic fistula after pancreaticoduodenectomy with surgical grading based on the 2016 Revised International Study Group of Pancreatic Fistula (ISGPF) classification.<bold>Methods: </bold>Between May 2011 and December 2016, 235 patients with periampullary tumor underwent pancreaticoduodenectomy and postoperative MDCT. Patients were classified into three groups (clinically no pancreatic fistula (cNo-PF), grade B, and grade C) according to the ISGPF classification. MDCT images were retrospectively evaluated by two radiologists in consensus for the presence of pancreaticojejunostomy (PJ) dehiscence, PJ dehiscence diameter, PJ defect, acute necrotic collection (ANC), peripancreatic fluid collection, and imaging findings of complications. Categorical MDCT findings were compared among the three groups using Pearson's chi-square test, and PJ dehiscence diameter was compared using the Kruskal-Wallis test.<bold>Results: </bold>There was no significant difference in patient demographics among the groups (cNo-PF = 133, grade B = 68, and grade C = 34), but the MDCT findings were significantly different regarding the presence of PJ dehiscence (p < 0.001), PJ defect (p < 0.001), ANC (p = 0.002), and imaging findings of total complications (p < 0.001). The diameters of PJ dehiscence were significantly different among the groups (cNo-PF [0.42 ± 1.54 mm], grade B [1.47 ± 2.33 mm], and grade C [5.38 ± 6.45 mm]) (p < 0.001).<bold>Conclusion: </bold>With respect to the presence of PF, postoperative MDCT findings may differ between surgical grading based on the ISGPF classification.<bold>Key Points: </bold>• Regarding the presence of pancreatic fistula, the postoperative multidetector CT findings correlate well with surgical grading based on the International Study Group of Pancreatic Fistula classification. • Multidetector CT may provide reliable information to suggest pancreatic fistula after pancreaticoduodenectomy.
- Subjects
PANCREATIC fistula; PANCREATICODUODENECTOMY; KRUSKAL-Wallis Test; CHI-squared test; GRADING of students; FOREIGN study; PANCREATIC tumors; REOPERATION; RESEARCH funding; SURGICAL complications; RETROSPECTIVE studies; RECEIVER operating characteristic curves; MULTIDETECTOR computed tomography
- Publication
European Radiology, 2019, Vol 29, Issue 5, p2399
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-018-5916-y