Usefulness of endoscopic ultrasonography-elastography as a predictive tool for the occurrence of pancreatic fistula after pancreatoduodenectomy

Takamichi Kuwahara, Yoshiki Hirooka, Hiroki Kawashima, Eizaburo Ohno, Yukihiro Yokoyama, Tsutomu Fujii, Shigeo Nakamura, Yasuhiro Kodera, Masato Nagino, Hidemi Goto

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Pancreatic fistula (PF) is a major complication following pancreatoduodenectomy (PD). Pancreatic texture is a risk factor for PF, but its evaluation depends on the subjective judgment. The aim of this study was to investigate whether preoperative endoscopic ultrasonography-elastography (EUS-EG), which objectively assesses tissue elasticity, predict the development of PF following PD. Methods: Fifty-nine patients who underwent EUS-EG before PD and had pancreas parenchyma histologically evaluated were included. Using histogram analysis, mean elasticity (ME), which represents tissue elasticity and is inversely correlated with pancreatic fibrosis, was calculated. Results: Among 59 patients, 19 developed PF (32.2%). The ME in patients with PF was significantly higher than that in patients without PF (85.4 vs. 55.6, P < 0.001). Area under the receiver operating characteristic curve for the accuracy of pancreatic texture and ME for predicting PF were 0.718 and 0.846, respectively. When a ME of 70.0 was used as a cut-off value for predicting PF, the sensitivity and specificity were 84.2% and 80.0%, respectively. In a multivariate logistic regression analysis, only a ME of >70.0 was an independent predictor of PF (odds ratio 10.02, P = 0.008). Conclusions: Endoscopic ultrasonography-elastography may be an accurate and objective method for predicting PF following PD.

Original languageEnglish
Pages (from-to)649-656
Number of pages8
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume24
Issue number12
DOIs
Publication statusPublished - 12-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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