Number of acinar cells at the pancreatic stump predicts pancreatic fistula after pancreaticoduodenectomy

Abstract

A large number of pancreatic acinar cells at the cut end of the stump is predictive of POPF after PD. Although POPF is associated with multiple factors and the number of acinar cells is only one of these, our study is the first to confirm this common intuition of surgeons, which has not been assessed definitively before.

Density and enhancement of the pancreatic tail on computer tomography predicts acinar score and pancreatic fistula after pancreatoduodenectomy

“…This study also demonstrates for the first time a significant correlation between CT radiodensity of the pancreas and the acinar score of the pancreatic resection margin, which previously has been established as inherent to the pathophysiology of post-pancreatectomy pancreatitis and POPF. 8,10 The present study also validated the significant association between the acinar score and the development of POPF. Given the morbidity and healthcare cost associated with POPF, it is critical to be able to predict this complication pre-operatively for detailed informed consent of the operative risks and clinical management.…”

“…This is significant, as it has previously been demonstrated that the acinar cell density at the pancreatic resection margin is the histological component most predictive of post-operative pancreatitis and POPF. [8][9][10] The present study aims to evaluate the association between the density of the pancreas on preoperative triple phase CT scan and (i) the acinar score of the pancreatic resection margin, and (ii) the development of POPF.…”

Estimated functional remnant pancreatic volume predicts nonalcoholic fatty liver disease after pancreaticoduodenectomy: use of computed tomography attenuation value of the pancreas

“…Previous studies have reported the pancreatic acinar cell density to be associated with the presence of POPF after PD. 21,22 Other reports have demonstrated that the CT attenuation value of the pancreas is associated with POPF after PD. [23][24][25] Moreover, Nahm et al reported the association of the pancreatic acinar cell density, the CT attenuation value, and POPF.…”

Gradient inflammation in the pancreatic stump after pancreaticoduodenectomy: Two case reports and review of literature

“…Additionally, various risk factors, including soft tissue texture, small pancreatic duct[ 30 ], ischemia, ductal obstruction, excessive blood loss, high intraoperative fluid intake[ 31 ], elevated bilirubin level, large body mass index[ 32 ], low fibrosis[ 33 ], high acinar cell density, and acinar marginal content[ 34 ], increase the complexity of surgical maneuvers, resulting in anastomotic failure due to the heightened local tension created by inflammation and reflux.…”