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Prediction of Postoperative Pancreatic Fistulas After Pancreatectomy: Assessment With Acoustic Radiation Force Impulse Elastography

 Tae Kil Lee  ;  Chang Moo Kang  ;  Mi-Suk Park  ;  Sung Hoon Choi  ;  Yong-Eun Chung  ;  Jin Young Choi  ;  Myeong-Jin Kim 
 Journal of Ultrasound in Medicine, Vol.33(5) : 781-786, 2014 
Journal Title
 Journal of Ultrasound in Medicine 
Issue Date
OBJECTIVES: The purpose of this prospective study was to investigate the usefulness of acoustic radiation force impulse (ARFI) elastography of the pancreas for predicting postoperative pancreatic fistula occurrence after pancreatic resection. METHODS: Twenty-five patients underwent ARFI elastography of the pancreas before pancreatic resection (11 men and 14 women; mean age, 59.1 years; range, 28-76 years). In each patient, 3 valid ARFI measurements (meters per second) were performed at the head of the pancreas, and the median values were calculated. Patients underwent pancreaticoduodenectomy (n = 18) or distal pancreatectomy (n = 7). Clinically relevant fistulas (grade B or higher) were determined according to the standard criteria used by the International Study Group on Pancreatic Fistula. Preoperative ARFI values were compared between the fistula and nonfistula groups (Mann-Whitney test). RESULTS: Clinically relevant fistulas (grade B or higher) were observed in 8 patients (32%; fistula group), including 5 of 18 patients with pancreaticoduodenectomy (28%) and 3 of 7 patients with distal pancreatectomy (43%). The ARFI values in the fistula group (median, 1.45 m/s; range, 0.80-1.98 m/s) were lower than in the nonfistula group (median, 1.54 m/s; range, 0.98-3.40 m/s), but there was no statistical significance (P = .1374). When confining the results to only patients with pancreaticoduodenectomy, the ARFI values were significantly lower in the patients with fistulas (median, 0.98 m/s; range, 0.80-1.94 m/s) than in those without fistulas (median, 1.60 m/s; range, 1.08-3.40 m/s; P = .0460). CONCLUSIONS: This preliminary study showed the potential feasibility of a clinical application of ARFI elastography in preoperatively predicting postoperative pancreatic fistulas after pancreaticoduodenectomy. Investigation of this method in larger studies is needed.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
강창무(Kang, Chang Moo) ORCID logo https://orcid.org/0000-0002-5382-4658
김명진(Kim, Myeong Jin) ORCID logo https://orcid.org/0000-0001-7949-5402
박미숙(Park, Mi-Suk) ORCID logo https://orcid.org/0000-0001-5817-2444
이태길(Lee, Tae Kil)
정용은(Chung, Yong Eun) ORCID logo https://orcid.org/0000-0003-0811-9578
최성훈(Choi, Sung Hoon)
최진영(Choi, Jin Young) ORCID logo https://orcid.org/0000-0002-9025-6274
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