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

Authors
 Tae Kil Lee  ;  Chang Moo Kang  ;  Mi-Suk Park  ;  Sung Hoon Choi  ;  Yong-Eun Chung  ;  Jin Young Choi  ;  Myeong-Jin Kim 
Citation
 JOURNAL OF ULTRASOUND IN MEDICINE, Vol.33(5) : 781-786, 2014 
Journal Title
JOURNAL OF ULTRASOUND IN MEDICINE
ISSN
 0278-4297 
Issue Date
2014
MeSH
Adult ; Aged ; Elasticity Imaging Techniques ; Feasibility Studies ; Female ; Humans ; Image Interpretation, Computer-Assisted/methods* ; Male ; Middle Aged ; Pancreatectomy/adverse effects* ; Pancreatic Fistula/diagnostic imaging* ; Pancreatic Fistula/etiology* ; Prognosis ; Reproducibility of Results ; Risk Assessment ; Sensitivity and Specificity ; Treatment Outcome
Keywords
acoustic radiation force impulse elastography ; gastrointestinal ultrasound ; pancreas ; pancreatectomy ; pancreatic fistula
Abstract
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.
Full Text
http://www.jultrasoundmed.org/content/33/5/781.long
DOI
10.7863/ultra.33.5.781
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
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Lee, Tae Kil(이태길)
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Sung Hoon(최성훈)
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98993
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