Acinar cells of the pancreas as an independent predictor of the development of postoperative pancreatic fistula: A review

Abstract

Analysis of data published in the modern literature on the role of the number of functioning acinar cells of the pancreas as a prognostic marker of the development of pancreatic fistula. The search for sources was carried out in the systems Clinicaltrials.gov, PubMed, Medline, NCCN, Scopus, Elibrary. In writing the literature review, 52 sources published from 2004 to 2022 were used. Included are studies reflecting the importance of functioning acinar cells at the edge of pancreatic resection, as well as other factors associated with the development of pancreatic fistula and other post-resection complications. A large number of acinar cells (40%) and a low collagen content (15%) in the edge of pancreatic resection significantly correlates with the development of pancreatic fistula. The content of adipose tissue in the edge of pancreatic resection showed no connection with the development of pancreatic fistula and other complications after surgery. Palpatory assessment of the structure of the pancreatic parenchyma is subjective and can lead to erroneous interpretation and adoption of inadequate tactics of preventive measures. Intraoperative counting of acinuses at the edge of pancreatic resection is easy to use, while not yielding to more complex methods for assessing the risk of post-resection complications and can be recommended as a routine method for predicting the occurrence of pancreatic fistula