BACKGROUND Some parameters using preoperative computed tomography (CT) have been evaluated to predict the development of pancreatic fistula (PF) after pancreaticoduodenectomy (PD). The present retrospective study evaluated the predictive value of pancreatic attenuation for PF after PD. METHODS A retrospective review was conducted of the patients who underwent PD between January 2010 and December 2014. The pancreatic attenuation was measured in unenhanced preoperative CT images. Pre- and intraoperative variables were analyzed for the risk of PF after PD. RESULTS Of the 346 consecutive patients, PF occurred in 116 (34%). The pancreatic attenuation was significantly greater in patients with PF than in those without PF (median, 40.0 vs. 33.3 Hounsfield units [HU], P < 0.001). A multivariate analysis showed that a pancreatic attenuation ≥30.0 HU (odds ratio [OR], 3.72; P < 0.001), a body mass index ≥25.0 kg/m2 (OR, 3.67; P < 0.001) and a diameter of the main pancreatic duct <3.0 mm (OR, 1.84; P = 0.034) were independent risk factors for PF after PD. CONCLUSION The degree of pancreatic attenuation on preoperative CT images was significantly associated with PF, and a pancreatic attenuation ≥30.0 HU was an independent risk factor of PF after PD.

中文翻译：

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电脑断层扫描显示的胰腺衰减可预测胰十二指肠切除术后的胰瘘。

背景技术已评估了使用术前计算机断层扫描（CT）的一些参数，以预测胰十二指肠切除术（PD）后胰瘘（PF）的发展。本回顾性研究评估了PD后胰腺衰减对PF的预测价值。方法回顾性分析2010年1月至2014年12月间行PD的患者。在未增强的术前CT图像中测量胰腺衰减。分析术前和术中变量以了解PD后发生PF的风险。结果在346例连续患者中，PF发生在116例中（占34％）。有PF的患者的胰腺衰减明显大于无PF的患者（中位数，40.0 vs. 33.3 Hounsfield单位[HU]，P <0.001）。多因素分析表明胰腺衰减≥30。0 HU（奇数比[OR]，3.72； P <0.001），体重指数≥25.0kg / m2（OR，3.67； P <0.001），主胰管直径<3.0 mm（OR，1.84； 1.0）。 P = 0.034）是PD后PD的独立危险因素。结论术前CT图像上的胰腺衰减程度与PF显着相关，胰腺衰减≥30.0 HU是PD后PF的独立危险因素。