The aim of this article is to assess whether measures of abdominal fat distribution, visceral density, and antropometric parameters obtained from computed tomography (CT) may predict postoperative pancreatic fistula (POPF) occurrence. We analyzed 117 patients who underwent pancreatoduodenectomy (PD) and had a preoperative CT scan as staging in our center. CT images were processed to obtain measures of total fat volume (TFV), visceral fat volume (VFV), density of spleen, and pancreas, and diameter of pancreatic duct. The predictive ability of each parameter was investigated by receiver-operating characteristic (ROC) curves methodology and assessing optimal cutoff thresholds. A stepwise selection method was used to determine the best predictive model. Clinically relevant (grades B and C) POPF occurred in 24 patients (20.5%). Areas under ROC-curves showed that none of the parameters was per se significantly predictive. The multivariate analysis revealed that a VFV >2334 cm3, TFV >4408 cm3, pancreas/spleen density ratio <0.707, and pancreatic duct diameter <5mm were predictive of POPF. The risk of POPF progressively increased with the number of factors involved and age. It is possible to deduce objective information on the risk of POPF from a simple and routine preoperative radiologic workup.

Sandini, M., Bernasconi, D., Ippolito, D., Nespoli, L., Baini, M., Barbaro, S., et al. (2015). Preoperative computed tomography to predict and stratify the risk of severe pancreatic fistula after pancreatoduodenectomy. MEDICINE, 94(31) [10.1097/MD.0000000000001152].

Preoperative computed tomography to predict and stratify the risk of severe pancreatic fistula after pancreatoduodenectomy

SANDINI, MARTA
;
BERNASCONI, DAVIDE PAOLO
Secondo
;
IPPOLITO, DAVIDE;NESPOLI, LUCA CARLO;BARBARO, SALVATORE;FIOR, DAVIDE
Penultimo
;
GIANOTTI, LUCA VITTORIO
Ultimo
2015

Abstract

The aim of this article is to assess whether measures of abdominal fat distribution, visceral density, and antropometric parameters obtained from computed tomography (CT) may predict postoperative pancreatic fistula (POPF) occurrence. We analyzed 117 patients who underwent pancreatoduodenectomy (PD) and had a preoperative CT scan as staging in our center. CT images were processed to obtain measures of total fat volume (TFV), visceral fat volume (VFV), density of spleen, and pancreas, and diameter of pancreatic duct. The predictive ability of each parameter was investigated by receiver-operating characteristic (ROC) curves methodology and assessing optimal cutoff thresholds. A stepwise selection method was used to determine the best predictive model. Clinically relevant (grades B and C) POPF occurred in 24 patients (20.5%). Areas under ROC-curves showed that none of the parameters was per se significantly predictive. The multivariate analysis revealed that a VFV >2334 cm3, TFV >4408 cm3, pancreas/spleen density ratio <0.707, and pancreatic duct diameter <5mm were predictive of POPF. The risk of POPF progressively increased with the number of factors involved and age. It is possible to deduce objective information on the risk of POPF from a simple and routine preoperative radiologic workup.
Articolo in rivista - Articolo scientifico
Adult; Aged; Body Fat Distribution; Female; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Outcome Assessment (Health Care); Pancreas; Pancreatic Fistula; Preoperative Care; ROC Curve; Retrospective Studies; Risk Assessment; Risk Factors; Decision Support Techniques; Pancreaticoduodenectomy; Postoperative Complications; Tomography, X-Ray Computed; Medicine (all)
English
2015
94
31
e1152
reserved
Sandini, M., Bernasconi, D., Ippolito, D., Nespoli, L., Baini, M., Barbaro, S., et al. (2015). Preoperative computed tomography to predict and stratify the risk of severe pancreatic fistula after pancreatoduodenectomy. MEDICINE, 94(31) [10.1097/MD.0000000000001152].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/101274
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