Efficacy of Peak Hounsfield Units of the Visceral Fat Area in Predicting Postoperative Complications after Pancreaticoduodenectomy.
Abdomen
/ diagnostic imaging
Adipocytes
/ pathology
Adult
Aged
Aged, 80 and over
Connective Tissue
/ diagnostic imaging
Female
Humans
Intra-Abdominal Fat
/ diagnostic imaging
Male
Middle Aged
Pancreatic Fistula
/ etiology
Pancreaticoduodenectomy
/ adverse effects
Postoperative Complications
/ etiology
Predictive Value of Tests
Retrospective Studies
Severity of Illness Index
Subcutaneous Fat
/ diagnostic imaging
Tomography, X-Ray Computed
Pancreatoduodenectomy
Postoperative complication
Visceral fat area
Journal
Digestive surgery
ISSN: 1421-9883
Titre abrégé: Dig Surg
Pays: Switzerland
ID NLM: 8501808
Informations de publication
Date de publication:
2020
2020
Historique:
received:
20
02
2019
accepted:
26
11
2019
pubmed:
24
1
2020
medline:
21
4
2021
entrez:
24
1
2020
Statut:
ppublish
Résumé
Morbidity following pancreaticoduodenectomy (PD) has been reported to remain high. This study sought to measure the peak Hounsfield units (HUs) of visceral attenuation in patients undergoing PD and to assess the quality of adipocytes by comparing these measurements with perioperative factors. Patients undergoing PD were retrospectively identified (n = 108). Abdominal perimeter, subcutaneous fat area (SFA), visceral fat area (VFA), and peak HU of the VFA were measured. Logistic regression analysis was used to identify independent predictors of postoperative pancreatic fistula (POPF) or complications. Histopathological examination was performed for qualitative diagnosis of the stromal tissue. The overall rate of POPF was 16%, and severe complications occurred in 23% of the cases. A criterion for peak HU of the VFA only independently predicted POPF (p = 0.007) in the multivariate analysis. A criterion for peak HU of the VFA (p = 0.015) was associated with an increased rate of postoperative severe complications in the univariate analysis. The peak HU of the VFA was significantly correlated with abdominal perimeter (p < 0.001) and VFA (p < 0.001). The peak HU of the VFA was significantly correlated with adipocyte diameter (p < 0.001) and the ratio of stromal connective tissue area around the adipocytes (p < 0.001). The peak HU of the VFA was an independent factor contributing to severe complications, including POPF after PD. It reflects the amount of stromal connective tissue around the adipocytes.
Sections du résumé
BACKGROUND
BACKGROUND
Morbidity following pancreaticoduodenectomy (PD) has been reported to remain high. This study sought to measure the peak Hounsfield units (HUs) of visceral attenuation in patients undergoing PD and to assess the quality of adipocytes by comparing these measurements with perioperative factors.
METHODS
METHODS
Patients undergoing PD were retrospectively identified (n = 108). Abdominal perimeter, subcutaneous fat area (SFA), visceral fat area (VFA), and peak HU of the VFA were measured. Logistic regression analysis was used to identify independent predictors of postoperative pancreatic fistula (POPF) or complications. Histopathological examination was performed for qualitative diagnosis of the stromal tissue.
RESULTS
RESULTS
The overall rate of POPF was 16%, and severe complications occurred in 23% of the cases. A criterion for peak HU of the VFA only independently predicted POPF (p = 0.007) in the multivariate analysis. A criterion for peak HU of the VFA (p = 0.015) was associated with an increased rate of postoperative severe complications in the univariate analysis. The peak HU of the VFA was significantly correlated with abdominal perimeter (p < 0.001) and VFA (p < 0.001). The peak HU of the VFA was significantly correlated with adipocyte diameter (p < 0.001) and the ratio of stromal connective tissue area around the adipocytes (p < 0.001).
CONCLUSION
CONCLUSIONS
The peak HU of the VFA was an independent factor contributing to severe complications, including POPF after PD. It reflects the amount of stromal connective tissue around the adipocytes.
Identifiants
pubmed: 31972560
pii: 000505060
doi: 10.1159/000505060
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
331-339Informations de copyright
© 2020 S. Karger AG, Basel.