Ann Surg Treat Res.  2016 Nov;91(5):254-259. 10.4174/astr.2016.91.5.254.

Does the abdominal ultrasonography reliable in the diagnosis of postoperative pancreatic fistula after pancreaticoduodenectomy in the first postoperative week?

• Kinaci E
• Sevinc MM
• Bayrak S
• Bektas CT
• Yardimci A
• Ozakay A

• KMID: 2356376
• DOI: http://doi.org/10.4174/astr.2016.91.5.254

Abstract

PURPOSE
We evaluated the efficacy of ultrasonography (US) in the early postoperative period after pancreaticoduodenectomy (PD) to diagnose postoperative-pancreatic-fistula (POPF). Early diagnosis is important to prevent POPF-dependent mortality after PD. The value of radiological modalities for early diagnosing POPF is not clear.
METHODS
Forty-five patients who underwent transabdominal-US in the first postoperative week after PD were retrospectively evaluated. Two types of grouping methods were performed. Firstly, peripancreatic or perianastomotic fluid collections at least 2 cm in diameter were considered to be a primary positive result on US. Patients then divided into 2 groups: group 1, US-positive and group 2, US-negative. Secondly, to increase the power of US, in addition to primary positive results, the presence of fever, leukocytosis or hyperamylasemia was considered to be a secondary positive result (group 1S). The remaining patients were considered to have secondary negative results (group 2S). The sensitivity and specificity for both grouping methods were calculated for the diagnosis of PF and clinically important PF (ciPF), according to the International Study Group on Pancreatic Fistula criteria.
RESULTS
For the first grouping method, the sensitivity was 36% and 28% and the specificity was 80% and 85% for PF and ciPF, respectively. For the second grouping method, the sensitivity was 36% and 29% and the spesificity was 74% and 81% for PF and ciPF, respectively. The unloculated fluid collections were not related to a significant increase in the risk of POPF (P = 0.694).
CONCLUSION
Abdominal-US has low sensitivity and high specificity for the early diagnosis of POPF after PD.

Keyword

Intra-abdominal fluid; Pancreatic fistula; Pancreaticoduodenectomy; Ultrasonography

MeSH Terms

Diagnosis*
Early Diagnosis
Fever
Humans
Hyperamylasemia
Leukocytosis
Methods
Mortality
Pancreatic Fistula*
Pancreaticoduodenectomy*
Postoperative Period
Retrospective Studies
Sensitivity and Specificity
Ultrasonography*

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