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The findings of the contrast-enhanced CT and risk factors for hepatic infarction after pancreatoduodenectomy

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Abstract

Purpose

Hepatic infarction is a relatively rare life-threatening complication after pancreatoduodenectomy (PD). Computed tomography (CT) findings and risk factors for hepatic infarctions after PD were investigated.

Methods

One hundred-fifty three patients who underwent contrast-enhanced CT (CECT) after PD between January 2011 and August 2016 were retrospectively analyzed. Hepatic infarction was defined as the non-contrast enhanced area expanding to the liver surface without mass effect on CECT. The relationships between infarctions and preoperative laboratory data or surgical procedures using uni- and multivariate analyses were examined.

Results

Twenty-nine patients showed 47 hepatic infarctions on CT. Infarctions most commonly appeared in segment 7 (S7) (17 lesions, 36.2%). Lesions were wedge-shaped in 12 patients and spread over multiple hepatic segments in 11 patients. Univariate analysis identified celiac artery (CA) or common hepatic artery (CHA) resection (p = 0.0029) and portal vein (PV) resection (p = 0.013) as risk factors for infarctions. CA or CHA resection (p = 0.038) remained as a significant factor after multivariate logistic analysis.

Conclusions

Hepatic infarctions after PD were most frequently seen in S7 and PV penetrating sign was characteristic CT findings. CA or CHA resection or PV resection were revealed as risk factors for hepatic infarctions.

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Funding

We state that this study has not received any funding.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Daisuke Shindo, Akira Yamamoto, Taro Shimono & Yukio Miki

  2. Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan

    Ryosuke Amano, Kenjiro Kimura & Sadaaki Yamazoe

Authors
  1. Daisuke Shindo
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  2. Akira Yamamoto
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  3. Ryosuke Amano
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  4. Kenjiro Kimura
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  5. Sadaaki Yamazoe
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  6. Taro Shimono
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  7. Yukio Miki
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Correspondence to Daisuke Shindo.

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All authors declare no conflicts of interest or sources of funding.

Informed consent

This study was described after approval by the institutional review board, and the requirement for informed consent from individual patients was waived.

Compliance with ethical standard

The study was approved by the local institutional review board and was conducted in accordance with the ethical standards of the 1964 Helsinki Declaration.

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Shindo, D., Yamamoto, A., Amano, R. et al. The findings of the contrast-enhanced CT and risk factors for hepatic infarction after pancreatoduodenectomy. Jpn J Radiol 38, 547–552 (2020). https://doi.org/10.1007/s11604-020-00934-4

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  • DOI: https://doi.org/10.1007/s11604-020-00934-4

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