Morphohistological features of pancreatic stump are the main determinant of pancreatic fistula after pancreatoduodenectomy

Cristina Ridolfi, Maria Rachele Angiolini, Francesca Gavazzi, Paola Spaggiari, Maria Carla Tinti, Fara Uccelli, Marco Madonini, Marco Montorsi, Alessandro Zerbi

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Introduction. Pancreatic surgery is challenging and associated with high morbidity, mainly represented by postoperative pancreatic fistula (POPF) and its further consequences. Identification of risk factors for POPF is essential for proper postoperative management. Aim of the Study. Evaluation of the role of morphological and histological features of pancreatic stump, other than main pancreatic duct diameter and glandular texture, in POPF occurrence after pancreaticoduodenectomy. Patients and Methods. Between March 2011 and April 2013, we performed 145 consecutive pancreaticoduodenectomies. We intraoperatively recorded morphological features of pancreatic stump and collected data about postoperative morbidity. Our dedicated pathologist designed a score to quantify fibrosis and inflammation of pancreatic tissue. Results. Overall morbidity was 59,3%. Mortality was 4,1%. POPF rate was 28,3%, while clinically significant POPF were 15,8%. Male sex (P=0.009), BMI≥25 (P=0.002), prolonged surgery (P=0.001), soft pancreatic texture (P

Original languageEnglish
Article number641239
JournalBioMed Research International
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Medicine(all)

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