Preoperative stratification of pancreas-related morbidity after the Whipple procedure.
Morbidity and mortality after pancreatoduodenectomy are greatly related to dehiscence of pancreatojejunostomy. We have analyzed risk factors of significance for and prediction of pancreas-related morbidity. We have retrospectively analyzed 122 patients. The relationship of fibrosis of pancreas, exocrine function, and diameter of pancreatic duct to pancreas-related morbidity was evaluated. Computer-aided morphometric analysis and the pancreatic elastase-1 stool test were used. Univariate analysis showed that the diameter of the main pancreatic duct and postoperative amylasemia were different in patients with and without pancreatic complications (P = 0.001 and P = 0.002, respectively). Pancreatic exocrine function was reduced and fibrosis was higher in patients without pancreatic complications (P = 0.003 and P = 0.026, respectively). Logistic regression analysis revealed exocrine pancreatic function as an independent risk factor. Pancreas-related morbidity is influenced by pancreatic fibrosis, diameter of pancreatic duct, and exocrine function. Preoperative evaluation of exocrine function allows detection of patients with minimal risk for pancreas-related morbidity.
Gulbinas
Antanas
A
Department of Surgery, Kaunas Medical University, Kaunas, Lithuania.
Barauskas
Giedrius
G
Pundzius
Juozas
J
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D005355:Fibrosis; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D010182:Pancreatic Diseases / Q000209:etiology*; D010186:Pancreatic Function Tests; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors