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The image-based preoperative fistula risk score (preFRS) predicts postoperative pancreatic fistula in patients undergoing pancreatic head resection.
Kolbinger, Fiona R; Lambrecht, Julia; Leger, Stefan; Ittermann, Till; Speidel, Stefanie; Weitz, Jürgen; Hoffmann, Ralf-Thorsten; Distler, Marius; Kühn, Jens-Peter.
Afiliação
  • Kolbinger FR; Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany. fiona.kolbinger@uniklinikum-dresden.de.
  • Lambrecht J; Division of Translational Surgical Oncology, National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany. fiona.kolbinger@uniklinikum-dresden.de.
  • Leger S; Else Kröner Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden, Dresden, Germany. fiona.kolbinger@uniklinikum-dresden.de.
  • Ittermann T; Institute and Policlinic for Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus Dresden, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
  • Speidel S; Division of Translational Surgical Oncology, National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany.
  • Weitz J; Else Kröner Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden, Dresden, Germany.
  • Hoffmann RT; Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
  • Distler M; Division of Translational Surgical Oncology, National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany.
  • Kühn JP; Else Kröner Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden, Dresden, Germany.
Sci Rep ; 12(1): 4064, 2022 03 08.
Article em En | MEDLINE | ID: mdl-35260701
Clinically relevant postoperative pancreatic fistula (CR-POPF) is a common severe surgical complication after pancreatic surgery. Current risk stratification systems mostly rely on intraoperatively assessed factors like manually determined gland texture or blood loss. We developed a preoperatively available image-based risk score predicting CR-POPF as a complication of pancreatic head resection. Frequency of CR-POPF and occurrence of salvage completion pancreatectomy during the hospital stay were associated with an intraoperative surgical (sFRS) and image-based preoperative CT-based (rFRS) fistula risk score, both considering pancreatic gland texture, pancreatic duct diameter and pathology, in 195 patients undergoing pancreatic head resection. Based on its association with fistula-related outcome, radiologically estimated pancreatic remnant volume was included in a preoperative (preFRS) score for POPF risk stratification. Intraoperatively assessed pancreatic duct diameter (p < 0.001), gland texture (p < 0.001) and high-risk pathology (p < 0.001) as well as radiographically determined pancreatic duct diameter (p < 0.001), gland texture (p < 0.001), high-risk pathology (p = 0.001), and estimated pancreatic remnant volume (p < 0.001) correlated with the risk of CR-POPF development. PreFRS predicted the risk of CR-POPF development (AUC = 0.83) and correlated with the risk of rescue completion pancreatectomy. In summary, preFRS facilitates preoperative POPF risk stratification in patients undergoing pancreatic head resection, enabling individualized therapeutic approaches and optimized perioperative management.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fístula Pancreática / Pancreaticoduodenectomia Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fístula Pancreática / Pancreaticoduodenectomia Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article