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Prediction of pancreatic fistula after pancreatoduodenectomy by preoperative dynamic CT and fecal elastase-1 levels

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dc.contributor.author강졍현-
dc.contributor.author김주희-
dc.contributor.author박준성-
dc.contributor.author유정식-
dc.contributor.author윤동섭-
dc.contributor.author정재준-
dc.contributor.author조은석-
dc.date.accessioned2017-11-02T08:22:54Z-
dc.date.available2017-11-02T08:22:54Z-
dc.date.issued2017-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/154402-
dc.description.abstractOBJECTIVE: To validate preoperative dynamic CT and fecal elastase-1 level in predicting the development of pancreatic fistulae after pancreatoduodenectomy. MATERIALS AND METHODS: For 146 consecutive patients, CT attenuation values of the nontumorous pancreatic parenchyma were retrospectively measured on precontrast, arterial and equilibrium phase images for calculation of enhancement ratios. CT enhancement ratios and preoperative fecal elastase-1 levels were correlated with the development of pancreatic fistulae using independent t-test, logistic regression models, ROC analysis, Youden method and tree analysis. RESULTS: The mean value of enhancement ratio on equilibrium phase was significantly higher (p = 0.001) in the patients without pancreatic fistula (n = 107; 2.26±3.63) than in the patients with pancreatic fistula (n = 39; 1.04±0.51); in the logistic regression analyses, it was significant predictor for the development of pancreatic fistulae (odds ratio = 0.243, p = 0.002). The mean preoperative fecal elastase-1 levels were higher (odds ratio = 1.003, p = 0.034) in the pancreatic fistula patients than other patients, but there were no significant differences in the areas under the curve between the prediction values of CT enhancement ratios and fecal elastase-1 combined and those of CT enhancement ratios alone (P = 0.897, p = 0.917) on ROC curve analysis. Tree analysis revealed that the CT enhancement ratio was more powerful predictor of pancreatic fistula than fecal elastase-1 levels. CONCLUSION: The preoperative CT enhancement ratio of pancreas acquired at equilibrium phase regardless of combination with fecal elastase-1 levels might be a useful predictor of the risk of developing a pancreatic fistula following pancreatoduodenectomy.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherPublic Library of Science-
dc.relation.isPartOfPLOS ONE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHLogistic Models-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPancreas/diagnostic imaging-
dc.subject.MESHPancreas/surgery*-
dc.subject.MESHPancreatic Ducts-
dc.subject.MESHPancreatic Elastase/analysis*-
dc.subject.MESHPancreatic Fistula/diagnosis*-
dc.subject.MESHPancreatic Fistula/diagnostic imaging-
dc.subject.MESHPancreatic Fistula/surgery*-
dc.subject.MESHPancreaticoduodenectomy-
dc.subject.MESHPreoperative Period-
dc.subject.MESHROC Curve-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHTomography, X-Ray Computed-
dc.titlePrediction of pancreatic fistula after pancreatoduodenectomy by preoperative dynamic CT and fecal elastase-1 levels-
dc.typeArticle-
dc.publisher.locationUnited States-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Radiology-
dc.contributor.googleauthorJung-Hyun Kang-
dc.contributor.googleauthorJoon Seong Park-
dc.contributor.googleauthorJeong-Sik Yu-
dc.contributor.googleauthorJae-Joon Chung-
dc.contributor.googleauthorJoo Hee Kim-
dc.contributor.googleauthorEun-Suk Cho-
dc.contributor.googleauthorDong Sup Yoon-
dc.identifier.doi10.1371/journal.pone.0177052-
dc.contributor.localIdA00951-
dc.contributor.localIdA01672-
dc.contributor.localIdA02500-
dc.contributor.localIdA02548-
dc.contributor.localIdA03712-
dc.contributor.localIdA03881-
dc.contributor.localIdA05079-
dc.relation.journalcodeJ02540-
dc.identifier.eissn1932-6203-
dc.identifier.pmid28493949-
dc.contributor.alternativeNameKang, Jung Hyun-
dc.contributor.alternativeNameKim, Joo Hee-
dc.contributor.alternativeNamePark, Joon Seong-
dc.contributor.alternativeNameYu, Jeong Sik-
dc.contributor.alternativeNameYoon, Dong Sup-
dc.contributor.alternativeNameChung, Jae Joon-
dc.contributor.alternativeNameCho, Eun Suk-
dc.contributor.affiliatedAuthorKim, Joo Hee-
dc.contributor.affiliatedAuthorPark, Joon Seong-
dc.contributor.affiliatedAuthorYu, Jeong Sik-
dc.contributor.affiliatedAuthorYoon, Dong Sup-
dc.contributor.affiliatedAuthorChung, Jae Joon-
dc.contributor.affiliatedAuthorCho, Eun Suk-
dc.contributor.affiliatedAuthorKang, Jung Hyun-
dc.citation.titlePLoS One-
dc.citation.volume12-
dc.citation.number5-
dc.citation.startPagee0177052-
dc.identifier.bibliographicCitationPLOS ONE, Vol.12(5) : e0177052, 2017-
dc.date.modified2017-11-01-
dc.identifier.rimsid42977-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers

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