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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jun 28, 2022; 14(6): 165-176
Published online Jun 28, 2022. doi: 10.4329/wjr.v14.i6.165
Published online Jun 28, 2022. doi: 10.4329/wjr.v14.i6.165
Do preoperative pancreatic computed tomography attenuation index and enhancement ratio predict pancreatic fistula after pancreaticoduodenectomy?
Senthil Gnanasekaran, Satish Durgesh, Ramprakash Gurram, Raja Kalayarasan, Biju Pottakkat, Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
M Rajeswari, Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Bheemanathi Hanuman Srinivas, Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
A Ramesh, Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Jayaprakash Sahoo, Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Author contributions: Gnanasekaran S and Kalayarasan R conceptualized the study; Durgesh S and Gurram R performed the research work; Rajeswari M performed the data analysis; Srinivas BH reviewed the histopathological slides for postoperative analysis; Ramesh A performed a preoperative radiological assessment of study participants; Durgesh S and Gurram R wrote the first draft of the manuscript; Gnanasekaran S, Kalayarasan R, Pottakkat B and Sahoo J gave intellectual input and critically revised the manuscript.
Institutional review board statement: The study was reviewed and approved by the institutional ethics committee (Human studies) of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India (JIP/IEC/2018/500 dated 25-01-2019). The study protocol can be fully accessed at https://jipmer.edu.in/.
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrolment.
Conflict-of-interest statement: All authors of this manuscript have no financial relationships to disclose.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raja Kalayarasan, DNB, MCh, MS, Additional Professor, Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Room No. 5442, 4th Floor, Super Specialty Block, Puducherry-605006, India.
Received: January 29, 2022
Peer-review started: January 29, 2022
First decision: April 10, 2022
Revised: April 26, 2022
Accepted: June 20, 2022
Article in press: June 20, 2022
Published online: June 28, 2022
Processing time: 150 Days and 5.9 Hours
Peer-review started: January 29, 2022
First decision: April 10, 2022
Revised: April 26, 2022
Accepted: June 20, 2022
Article in press: June 20, 2022
Published online: June 28, 2022
Processing time: 150 Days and 5.9 Hours
Core Tip
Core Tip: The prospective observational study evaluated the accuracy of the pancreatic computed tomography indices in predicting clinically relevant pancreatic fistula after pancreaticoduodenectomy. Though the predictive accuracy of pancreatic attenuation index (PAI) was low, pancreatic enhancement ratio (PER) exhibited good accuracy in predicting the development of clinically relevant postoperative pancreatic fistula (CR-POPF). Also, PER showed a statistically significant weak negative correlation with PAI and moderately positive correlation with fibrosis scores suggesting that PER may be an objective preoperative surrogate for assessing pancreatic texture. Preoperative quantification of PER can improve the risk stratification and management of patients at high risk of CR-POPF.