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Pancreatic ultrasound elastography is not useful to predict the risk of pancreatic fistulas after pancreatic resection

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Abstract

The clinical usefulness of pancreatic elastography (PE) in the assessment of the pancreatic texture before pancreatic resection still remains uncertain. The aims are: to evaluate the value of pancreatic stiffness in both healthy volunteers and patients affected by pancreatic tumor; to evaluate the ability of PE in predicting clinically relevant postoperative pancreatic fistula (CR-POPF). Pancreatic stiffness of healthy subjects was compared with those of pancreatic tumors measuring shear wave velocity (SWV). In the last group, the ability of preoperative SWV in predicting CR-POPF was evaluated using linear regression. Ninety subjects were consecutively enrolled. No difference was found in SWV in the two groups (1.33 ± 0.31 vs 1.26 ± 0.30, p = 0.337). Multivariate analyses showed that male gender was associated with a softer pancreas (OR 0.74, CI 0.55–0.98, p = 0.035). In the 45 patients suitable for a secondary endpoint, the presence of soft pancreas assessed by surgeon’s palpation (OR 61.21; CI 2.14– > 1000; p = 0.016) and preoperative risk score (OR 1.72; CI 1.01–2.96; p = 0.049) was predictors of CR-POPF. SWV showed a trend in predicting CR-POPF. The pancreatic stiffness far to the pancreatic neoplasm is the same as healthy controls. SWV showed a trend in predicting CR-POPF but the clinical utility is limited.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, Bologna, 40138, Italy

    Giovanni Marasco, Claudio Ricci, Valentina Grasso, Margherita Alvisi, Federico Ravaioli & Riccardo Casadei

  2. Department of Organ Failure and Transplantation, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy

    Carla Serra

  3. Gastroenterology Unit, University Hospital Borgo Trento, P.le Aristide Stefani 1, Verona, 37126, Italy

    Antonio Colecchia

Authors
  1. Giovanni Marasco
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  2. Claudio Ricci
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  3. Valentina Grasso
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  4. Margherita Alvisi
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  6. Federico Ravaioli
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  7. Riccardo Casadei
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  8. Antonio Colecchia
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Correspondence to Antonio Colecchia.

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Giovanni Marasco and all co-authors declared that they not have a conflict of interest and they did not received funding for the manuscript.

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This study has been approved by the Institutional ethic committee of our hospital, and was in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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This study does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from each patient involved in this study.

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Marasco, G., Ricci, C., Grasso, V. et al. Pancreatic ultrasound elastography is not useful to predict the risk of pancreatic fistulas after pancreatic resection. Updates Surg 72, 1081–1087 (2020). https://doi.org/10.1007/s13304-020-00748-z

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  • DOI: https://doi.org/10.1007/s13304-020-00748-z

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