Study for preoperative prediction of clinical relevant postoperative pancreatic fistula for safety early removal of drains

2017 Fiscal Year Final Research Report

• Project/Area Number: 26462057
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Digestive surgery
• Research Institution: Kanazawa University
• Principal Investigator: Kitagawa Hirohisa 金沢大学, 医学系, 協力研究員 (80272970)
• Co-Investigator(Kenkyū-buntansha): 井上 大 金沢大学, 附属病院, 助教 (00645129) ; 牧野 勇 金沢大学, 医学系, 助教 (30543657)
• Project Period (FY): 2014-04-01 – 2018-03-31
• Keywords: 膵液瘻 / 膵頭十二指腸切除術後 / 術前予測因子 / MDCT / MRI / 主膵管径 / 膵実質径 / 組織学的膵線維化率

Outline of Final Research Achievements

Reposition of drains or reoperation after early removal of drains in patients with pancrearic head resection is harmful and stressful for both patients and surgeons. The aim of this study is to clarify objective predictive parameters of clinical relevant postoperative pancreatic fistula (CR-POPF) preoperatively. We investigated high risk factors for CR-POPF in surgical factors, morphologic and imaging factors from CT or MRI and proportion of fibrous tissue and adipose tissue at cut margin of the pancreas. Histological fibrous ratio of pancreas, morphologic ratio of [width of the pancreas] / [diameter of main pancreatic duct] by CT axial imaging and CT value ratio of [pancreatic parenchyma] / [erector spinae muscles] in late phase are statistically significant factors. Latter two factors are preoperative predictive factors. Careful management of drain for high risk group makes early removal of drains safer.

Free Research Field

膵臓外科学