TY - JOUR
T1 - Functional, biological, and radiological evaluation of the pancreaticojejunal anastomosis 1 year after pancreatoduodenectomy
T2 - a prospective study
AU - Joliat, Gaëtan Romain
AU - Allemann, Pierre
AU - Labgaa, Ismail
AU - Demartines, Nicolas
AU - Vietti Violi, Naik
AU - Schmidt, Sabine
AU - Schäfer, Markus
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Purpose: This prospective study aimed to analyze the functional, biological, and radiological aspects of the pancreatic anastomosis 1 year after pancreatoduodenectomy (PD). Methods: From 2016 to 2019, patients with PD indication were screened. Questionnaires about pancreas insufficiency, fecal elastase tests, and magnetic resonance imaging (MRI) were performed before and 1 year after PD. Results: Twenty patients were prospectively included. The only difference between pre- and postoperative questionnaires was constipation (less frequent 1 year after PD). Median pre- and postoperative fecal elastase levels were 96 μg/g (IQR 15–196, normal value > 200) and 15 μg/g (IQR 15–26, p = 0.042). There were no significant differences in terms of main pancreatic duct (MPD) size (4, IQR 3–5 vs. 4 mm, IQR 3–5, p = 0.892), border regularity, stenosis, visibility, image improvement, and secondary pancreatic duct dilation before and after secretin injection. All patients but one (2 refused and 2 were lost to follow-up, 15/16, 94%) had a patent pancreaticojejunal anastomosis on 1-year MRI. Conclusion: Although median 1-year fecal elastase was significantly lower than preoperatively, suggesting that exocrine secretion was altered, the anatomical outcome as assessed by MRI was excellent showing high patency rate (15/16, 94%) at 1 year. This emphasizes the difference between anatomy and function.
AB - Purpose: This prospective study aimed to analyze the functional, biological, and radiological aspects of the pancreatic anastomosis 1 year after pancreatoduodenectomy (PD). Methods: From 2016 to 2019, patients with PD indication were screened. Questionnaires about pancreas insufficiency, fecal elastase tests, and magnetic resonance imaging (MRI) were performed before and 1 year after PD. Results: Twenty patients were prospectively included. The only difference between pre- and postoperative questionnaires was constipation (less frequent 1 year after PD). Median pre- and postoperative fecal elastase levels were 96 μg/g (IQR 15–196, normal value > 200) and 15 μg/g (IQR 15–26, p = 0.042). There were no significant differences in terms of main pancreatic duct (MPD) size (4, IQR 3–5 vs. 4 mm, IQR 3–5, p = 0.892), border regularity, stenosis, visibility, image improvement, and secondary pancreatic duct dilation before and after secretin injection. All patients but one (2 refused and 2 were lost to follow-up, 15/16, 94%) had a patent pancreaticojejunal anastomosis on 1-year MRI. Conclusion: Although median 1-year fecal elastase was significantly lower than preoperatively, suggesting that exocrine secretion was altered, the anatomical outcome as assessed by MRI was excellent showing high patency rate (15/16, 94%) at 1 year. This emphasizes the difference between anatomy and function.
KW - Cancer
KW - Complication
KW - Pancreatectomy
KW - Permeability
UR - http://www.scopus.com/inward/record.url?scp=85168522196&partnerID=8YFLogxK
U2 - 10.1007/s00423-023-03040-x
DO - 10.1007/s00423-023-03040-x
M3 - Article
C2 - 37606699
AN - SCOPUS:85168522196
SN - 1435-2443
VL - 408
JO - Langenbeck's Archives of Surgery
JF - Langenbeck's Archives of Surgery
IS - 1
M1 - 326
ER -