Preoperative Cross-Sectional Area and Thickness of Pancreatic Stump as Possible Predictors of Pancreatic Fistula and Pseudocyst following Laparoscopic Distal Pancreatectomy: A Retrospective Study

Abstract

Abstract Purpose This retrospective study investigates the association between the preoperative radiographic measurements of pancreatic thickness, cross-sectional area and the postoperative outcomes in laparoscopic distal pancreatectomy (DP) patients. Methods A total of 27 patients who underwent DP between May 2019 and February 2022 were included. Preoperative thoracoabdominal computed tomography (CT) measurements of pancreatic thickness and cross-sectional area were analyzed for their potential role in predicting postoperative pancreatic fistula (POPF) and pseudocyst formation. Results Our findings revealed a significant correlation between pancreatic thickness and amylase levels in the drain fluid on postoperative day one (POD1). Furthermore, pancreatic thickness emerged as a robust predictor for the formation of postoperative pancreatic pseudocysts. Notably, no significant association was observed between the cross-sectional area of the pancreas and either the drain amylase levels or pseudocyst formation. Conclusions These findings accentuate the potential role of preoperative CT evaluation, specifically the measurement of pancreatic thickness, in predicting the risk of POPF and pseudocyst formation after DP. It can contribute to tailored perioperative procedures and strategic patient management, ultimately enhancing patient outcomes. The present study underscores the importance of incorporating radiographic assessments into preoperative planning for patients undergoing DP.