Background: To determine the precise frequency of main pancreatic duct (MPD) dilatation within the remnant pancreas at 1 year after pancreatoduodenectomy (PD) and its clinical implications, a prospective multicenter cohort study was performed in patients without MPD dilatation before PD (registry number: UMIN000029662).
Study Design: Between October 2017 and July 2020, patients with an MPD diameter less than 3 mm who were planned to undergo PD for periampullary lesions at 21 hospitals were enrolled. The primary endpoints were frequency of MPD dilatation at 1 year after PD, and the relationship between MPD dilatation and pancreatic endo- and exocrine function, nutritional status, and fatty liver. Secondary endpoints were risk factors for MPD dilatation at 1 year after PD and time-course change in MPD diameter.
Results: Of 200 registered patients, 161 patients were finally analyzed. Pancreatic fistula was the most frequent complication (76; 47.2%). MPD dilatation (MPD > 3 mm) at 1 year after PD was seen in 35 patients (21.7%). Pancreatic exocrine function, assessed by steatorrhea, was significantly impaired in patients with MPD dilatation. However, endocrine function, nutrition status, and fatty liver development were comparable between the 2 groups. In multivariate analysis, the serum total protein level 7.3 g/dL or more was an independent predictor for MPD dilatation at 1 year after PD (odds ratio 3.12, 95% CI 1.31 to 7.15). A mean MPD diameter significantly increased at 6 months after PD and kept plateau thereafter.
Conclusions: MPD dilatation at 1 year after PD was seen in 21.7% of patients and significantly associated with exocrine function impairment but not with endocrine function, nutrition status, or development of fatty liver.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/XCS.0000000000001121 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A case of pancreatic acinar cell carcinoma implantation in multiple branches of the pancreatic duct without main tumor continuity: a rare case report.
J Gastrointest Oncol
December 2024
Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan.
Background: Pancreatic acinar cell carcinoma (PACC) is a rare subtype of pancreatic cancer and the clinicopathological behavior of PACC is not yet fully understood. PACC rarely invades the main pancreatic duct (MPD), which causes intraductal growth. Thus, herein, we have reported a rare case of PACC that invaded the MPD and disseminated to the branches of the pancreatic duct (BDs) without exhibiting any continuity with the main tumor.
View Article and Find Full Text PDFGenome-wide association analysis provides insights into the molecular etiology of dilated cardiomyopathy.
Nat Genet
December 2024
Institute of Health Informatics, University College London, London, UK.
Article Synopsis
- Dilated cardiomyopathy (DCM) is a major cause of heart failure, and this study analyzes genetic factors by examining 14,256 DCM cases and 36,203 participants from the UK Biobank for related traits.
- Researchers discovered 80 genomic risk loci and pinpointed 62 potential effector genes tied to DCM, including some linked to rare variants.
- The study uses advanced transcriptomics to explore how cellular functions contribute to DCM, showing that polygenic scores can help predict the disease in the general population and emphasize the importance of genetic testing and development of precise treatments.
Prediction of clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy based on multifrequency magnetic resonance elastography.
J Gastrointest Surg
November 2024
Department of Pancreatobiliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China. Electronic address:
Background: Clinically relevant postoperative pancreatic fistula (CR-POPF) is the major complication of pancreatoduodenectomy, and the pancreatic texture is one of the potential affecting factors. Multifrequency magnetic resonance elastography (MRE) is a novel technique for measuring tissue stiffness, but its value in predicting CR-POPF preoperatively has not been well documented.
Methods: A total of 70 patients who underwent multifrequency MRE before pancreatoduodenectomy between July 2021 and April 2024 were retrospectively recruited into the study.
Preoperative prognostic stratification and prediction of long-term outcomes after pancreatoduodenectomy for distal cholangiocarcinoma.
Eur J Surg Oncol
December 2024
Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Yamane, Hidaka-City, Saitama-Pref, Japan.
Article Synopsis
- Patients with distal cholangiocarcinoma (DCC) often receive chemotherapy, but predicting their survival risk during treatment selection is difficult.
- This study analyzed 170 DCC patients who underwent pancreatoduodenectomy between 2009 and 2022, using various clinical parameters to identify overall survival (OS) risk factors through Cox regression analysis.
- Key findings showed that tumor size ≥15 mm and main pancreatic duct dilatation (≥3 mm) significantly impacted OS; patients with two risk factors had a poor 5-year OS of only 8%, suggesting that more aggressive treatment options should be considered for these individuals.
Main pancreatic duct involved IPMN without high-risk factors: how to judge the degree of malignancy based on MPD dilation?
Medicine (Baltimore)
August 2024
Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.
Article Synopsis
- * Researchers analyzed data from 142 patients with either main pancreatic duct (MPD)-involved or branch-duct intraductal papillary mucinous neoplasms (IPMNs) and used statistical methods to identify malignant risk factors.
- * They found that an MPD diameter greater than 7.5 mm and elevated levels of a specific tumor marker (Ca19-9) were significant predictors of malignant IPMNs, with their combined use improving diagnostic accuracy.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!