Assessing the Role of Pancreatic Duct and Consistency in Forecasting Post-Pancraticodoudenectomy Pancreatic Fistula; A prospective Study | ||
| The Egyptian Journal of Surgery | ||
| Volume 44, Issue 3, July 2025, Pages 1085-1094 PDF (758.68 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2025.357595.1377 | ||
| Authors | ||
| Ibrahim M. Abdelaal* ; Salah I. Mohamed; Mahmoud S. Mekhemer; Mostafa S. Meshref | ||
| Department of General Surgery, Faculty of Medicine, Assiut University, Egypt | ||
| Abstract | ||
| Background and Aim: Postoperative pancreatic fistula (POPF) is one of the serious complications that can happen after pancreatic surgery, especially pancreaticoduodenectomy. The morbidity after pancreatic resection was mainly caused by POPF. Clinical prediction patterns have been proposed with the anticipation of detecting patients who have high risk of POPF. Persistent abdominal pain, vomiting, and postoperative secondary hemorrhage might suggest the occurrence of POPF. The current study aimed to detect possible risk factors for POPF involved size of pancreatic duct, consistency of the pancreas (soft or firm), intraoperative blood loss, etc. Methods: In our study we prospectively analyzed the factors which are associated with postoperative pancreatic fistula formation following pancreaticoduodenectomy. This research was accomplished at the General Surgery Department in Assiut University Hospitals and Al-Rajhi Liver Hospital from March 2023 till March 2024. A total of 62 patients were scheduled for pancreaticoduodenectomy were enrolled. Results: The patients had a mean age of 54.40±12.82 years. The utmost frequent diagnosis in the studied patients was pancreatic cancer (59.7%). A wound infection was reported in 15(24.2%) patients. Length of stay was <7 and >7 days in 34(54.8%) and 28(45.2%) patients, respectively. POPF occurred in 16(25.8%) patients. patients with POPF had significantly higher mean age (60.34±5.67 vs. 44.66±8.90 (years), mean body mass index (19.45±2.22 vs. 23.03±2.89(kg/m2) and lower albumin (32.09±2.19 vs. 39.44±4.21(mg/dl). Also, majority of patients with POPF had soft pancreatic consistency (68.8%) and small pancreatic duct (68.8%). Predictors of POPF were low albumin, soft pancreatic consistency and small pancreatic duct. Soft pancreatic consistency had 84.5% accuracy for prediction POPF. Meanwhile, small pancreatic duct had 81.2% accuracy. Also, low albumin had 63% sensitivity, 67% specificity and 66% accuracy for prediction POPF Conclusion: Patients with soft pancreatic consistency with small pancreatic duct are more liable to POPF. Strict follow of those risky patients after pancreatoduodenectomy is highly recommended. Future work, including a larger number of patients, is assured to verify such results. | ||
| Keywords | ||
| Pancreatic fistula; Pancreatic duct; Pancreatoduodenectomy; Soft pancreatic consistency | ||
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