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Efficacy of Peak Hounsfield Units of the Visceral Fat Area in Predicting Postoperative Complications after Pancreaticoduodenectomy.
Hikita, Kosuke; Chiba, Naokazu; Nakagawa, Masashi; Koganezawa, Itsuki; Yokozuka, Kei; Kobayashi, Toshimichi; Sano, Toru; Tomita, Koichi; Tsutsui, Rina; Hirano, Hiroshi; Kawachi, Shigeyuki.
Affiliation
  • Hikita K; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Chiba N; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan, nchiba0632@yahoo.co.jp.
  • Nakagawa M; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Koganezawa I; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Yokozuka K; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Kobayashi T; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Sano T; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Tomita K; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Tsutsui R; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Hirano H; Department of Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Kawachi S; Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
Dig Surg ; 37(4): 331-339, 2020.
Article in En | MEDLINE | ID: mdl-31972560
BACKGROUND: Morbidity following pancreaticoduodenectomy (PD) has been reported to remain high. This study sought to measure the peak Hounsfield units (HUs) of visceral attenuation in patients undergoing PD and to assess the quality of adipocytes by comparing these measurements with perioperative factors. METHODS: Patients undergoing PD were retrospectively identified (n = 108). Abdominal perimeter, subcutaneous fat area (SFA), visceral fat area (VFA), and peak HU of the VFA were measured. Logistic regression analysis was used to identify independent predictors of postoperative pancreatic fistula (POPF) or complications. Histopathological examination was performed for qualitative diagnosis of the stromal tissue. RESULTS: The overall rate of POPF was 16%, and severe complications occurred in 23% of the cases. A criterion for peak HU of the VFA only independently predicted POPF (p = 0.007) in the multivariate analysis. A criterion for peak HU of the VFA (p = 0.015) was associated with an increased rate of postoperative severe complications in the univariate analysis. The peak HU of the VFA was significantly correlated with abdominal perimeter (p < 0.001) and VFA (p < 0.001). The peak HU of the VFA was significantly correlated with adipocyte diameter (p < 0.001) and the ratio of stromal connective tissue area around the adipocytes (p < 0.001). CONCLUSION: The peak HU of the VFA was an independent factor contributing to severe complications, including POPF after PD. It reflects the amount of stromal connective tissue around the adipocytes.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Postoperative Complications / Tomography, X-Ray Computed / Pancreatic Fistula / Pancreaticoduodenectomy / Intra-Abdominal Fat Type of study: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Dig Surg Journal subject: GASTROENTEROLOGIA Year: 2020 Type: Article Affiliation country: Japan

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Postoperative Complications / Tomography, X-Ray Computed / Pancreatic Fistula / Pancreaticoduodenectomy / Intra-Abdominal Fat Type of study: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Dig Surg Journal subject: GASTROENTEROLOGIA Year: 2020 Type: Article Affiliation country: Japan