TY - JOUR
T1 - Perioperative acinar cell count method works well in the prediction of postoperative pancreatic fistula and other postoperative complications after pancreaticoduodenectomy
AU - Teränen, Ville
AU - Rinta-Kiikka, Irina
AU - Holli-Helenius, Kirsi
AU - Laaninen, Matias
AU - Sand, Juhani
AU - Laukkarinen, Johanna
N1 - Funding Information:
We thank statistician Mika Helminen (Tampere University) for comments on the statistical analysis, research assistant Satu J?rvinen (Tampere University Hospital) for archive management and Virginia Mattila for proof reading. This work was supported by State Research Funding (VTR), Finland, and the Sigrid Juselius Foundation, Finland. They have no involvements in the study design, data collection, data analysis, manuscript preparation or publication decisions.
Funding Information:
This work was supported by State Research Funding (VTR), Finland, and the Sigrid Juselius Foundation , Finland. They have no involvements in the study design, data collection, data analysis, manuscript preparation or publication decisions.
Publisher Copyright:
© 2021 IAP and EPC
PY - 2021
Y1 - 2021
N2 - Background: Earlier we have shown that high frequency of acinar cells in the pancreatic transsection line predicts postoperative pancreatic fistula after pancreaticoduodenectomy (PD). Acinar cell count method (ACM) is fast to perform during operation. In this study our aim was to validate the accuracy of ACM to compare it with other published risk prediction methods. Methods: 87 patients who underwent PD without any trial including perioperative medications were collected from a single hospital. Data on demographics, surgical details, postoperative complications clinically relevant pancreatic fistulae (CR-POPF) and clinically relevant Clavien-Dindo complications (CR-CDC) were registered. Thirteen previously published risk prediction methods were included in the comparison, such as pancreatic duct diameter, palpable texture of pancreas, Braga score (BC), Fistula Risk Score, Modified Fistula Risk Score, Alternative Fistula Risk Score and multiple radiological parameters. ROC-curves were calculated to compare sensitivity and specificity for identifying high risk patients for CR-POPF and CR-CDC. Results: The three most accurate risk prediction methods for CR-POPF were ACM (sensitivity 88.9%, specificity 52.6%; p = 0.043), BC (87.5%, 56.6%; p = 0.039) and visceral fat area to subcutaneous fat area ratio (75.5%, 80.0%; p = 0.032). In predicting CR-CDC the three most accurate methods were ACM (73.9%, 56.2%; p = 0.033), BC (68.4%, 59.5%; p = 0.036) and TPAI (78.3%, 41.7%; p = 0.012). Conclusion: ACM was shown to be as good as the more complicated risk scoring methods in the prediction of CR-POPF. It was good also in predicting all clinically relevant complications. ACM is easy to use during operation and can be recommended as a routine risk prediction method.
AB - Background: Earlier we have shown that high frequency of acinar cells in the pancreatic transsection line predicts postoperative pancreatic fistula after pancreaticoduodenectomy (PD). Acinar cell count method (ACM) is fast to perform during operation. In this study our aim was to validate the accuracy of ACM to compare it with other published risk prediction methods. Methods: 87 patients who underwent PD without any trial including perioperative medications were collected from a single hospital. Data on demographics, surgical details, postoperative complications clinically relevant pancreatic fistulae (CR-POPF) and clinically relevant Clavien-Dindo complications (CR-CDC) were registered. Thirteen previously published risk prediction methods were included in the comparison, such as pancreatic duct diameter, palpable texture of pancreas, Braga score (BC), Fistula Risk Score, Modified Fistula Risk Score, Alternative Fistula Risk Score and multiple radiological parameters. ROC-curves were calculated to compare sensitivity and specificity for identifying high risk patients for CR-POPF and CR-CDC. Results: The three most accurate risk prediction methods for CR-POPF were ACM (sensitivity 88.9%, specificity 52.6%; p = 0.043), BC (87.5%, 56.6%; p = 0.039) and visceral fat area to subcutaneous fat area ratio (75.5%, 80.0%; p = 0.032). In predicting CR-CDC the three most accurate methods were ACM (73.9%, 56.2%; p = 0.033), BC (68.4%, 59.5%; p = 0.036) and TPAI (78.3%, 41.7%; p = 0.012). Conclusion: ACM was shown to be as good as the more complicated risk scoring methods in the prediction of CR-POPF. It was good also in predicting all clinically relevant complications. ACM is easy to use during operation and can be recommended as a routine risk prediction method.
KW - Acinar cell
KW - Complications
KW - Pancreatic fistula
KW - Pancreatoduodenectomy
KW - Risk score
U2 - 10.1016/j.pan.2021.01.005
DO - 10.1016/j.pan.2021.01.005
M3 - Article
C2 - 33531257
AN - SCOPUS:85100396074
SN - 1424-3903
VL - 21
SP - 487
EP - 493
JO - Pancreatology
JF - Pancreatology
IS - 2
ER -