Pancreatoduodenectomy Clinical Trial
Official title:
Impact of the Neck Division Level During Pancreaticoduodenectomy on Postoperative Pancreatic Fistula?
Brief Summary:*
Aim of the study :
To evaluate if the neck division level significantly influences the postoperative pancreatic
fistula rate of pancreatico-jejunal anastomosis after pancreatoduodenectomy.
Methods :
Patients who underwent oncologic or non-oncologic pancreatoduodenectomy between 01 January
2009 and 04 April 2018 will be included in this retrospective analysis. Two independent
radiologists will measure the distance between the left side of the portal vein and the
remnant pancreatic stump on post operative CT scan, blindly for postoperative course. This
new variable will be integrated in a logistic regression model in addition to well known risk
factors of POPF.
The pancreatic neck is an anatomical area mainly vascularized by the arterial network derived
from the gastroduodenal artery and branches of the superior mesenteric artery running in the
pancreatic head.
The neck arterial blood supply is probably reduced after pancreatoduodenectomy due to the
ligation of gastroduodenal artery and collaterals of superior mesenteric artery.
Postoperative pancreatic fistula (POPF) is the main complication after pancreatoduodenectomy.
POPF has an estimated rate of 15 to 30%. So, this complication is frequent and could be
lethal. Several studies have been driven to identify risks factors of POPF but there are no
actual data on the impact of the neck division level and neck vascularization on POPF.
By considering the level of neck division is variable, the investigator hypothesize that a
long remnant neck, is a risk factor of POPF after pancreatoduodenectomy with pancreatojejunal
anastomosis.
The aim of the present study is to integrate this new variable in a logistic regression model
in addition to well known risk factors of POPF.
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