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The clinical management of peripancreatic fluid collection after distal pancreatectomy

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Abstract

Purpose

Peripancreatic fluid collection (PFC) is a frequent radiological finding on postoperative computed tomography (CT) after distal pancreatectomy (DP). We evaluated the risk factors for drainage of PFC after DP to clarify the optimal management of PFC.

Methods

This study included 85 patients who underwent elective DP between January 2010 and December 2020. PFC was defined as an area of fluid located at the pancreatic resection margin on postoperative routine CT on approximately postoperative day 7 (first CT). We retrospectively investigated the relationship between clinical variables, including CT findings and PFC drainage.

Results

Drainage was performed in 19 patients (22.4%). Drainage for PFC was significantly associated with a longer postoperative hospital stay, higher PFC volume, presence of air bubbles, and higher white blood cell (WBC) count at the time of the first CT. According to the multivariate analyses, a PFC volume ≥ 60 mL and WBC count ≥ 12,400/μL on the day of the first CT were independent risk factors for PFC drainage after DP. The combination of these 2 factors showed 73.7% sensitivity and 90.9% specificity.

Conclusion

The PFC volume and WBC count at the first CT were significantly associated with PFC drainage and may help determine the appropriate treatment.

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Funding

This work was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number 20K17665 (Dr. Yoshihiro Shirai).

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Authors and Affiliations

  1. Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Masashi Tsunematsu, Yoshihiro Shirai, Ryoga Hamura, Tomohiko Taniai, Mitsuru Yanagaki, Koichiro Haruki, Kenei Furukawa, Shinji Onda, Yoichi Toyama, Takeshi Gocho & Toru Ikegami

Authors
  1. Masashi Tsunematsu
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  2. Yoshihiro Shirai
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  3. Ryoga Hamura
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  4. Tomohiko Taniai
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  5. Mitsuru Yanagaki
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  6. Koichiro Haruki
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  7. Kenei Furukawa
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  8. Shinji Onda
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  9. Yoichi Toyama
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  10. Takeshi Gocho
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  11. Toru Ikegami
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Corresponding author

Correspondence to Yoshihiro Shirai.

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The authors declare no conflicts of interest in association with the present study.

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Tsunematsu, M., Shirai, Y., Hamura, R. et al. The clinical management of peripancreatic fluid collection after distal pancreatectomy. Surg Today 52, 1524–1531 (2022). https://doi.org/10.1007/s00595-022-02483-x

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  • DOI: https://doi.org/10.1007/s00595-022-02483-x

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