Risk factors and prevention of postoperative pancreatic fistula after insulinoma enucleation:a retrospective study from a high-volume center
Enucleation is an effective surgical method to treat pancreatic insulinoma, however, the incidence of clinically relevant postoperative pancreatic fistula (CR-POPF) is high. We aim to investigate the risk factors for CR-POPF which have not been well characterized and develop effective methods to pre...
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| Veröffentlicht in: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2021-09, Vol.21 (6), p.1208-1215 |
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| creator | Xu, Qiang Xie, Qiankun Ge, Chenghao Zou, Xi Gao, Ruichen Liu, Qiaofei Kang, Kai Zhu, Liang Wang, Qiang Han, Xianlin Liao, Quan Dai, Menghua Zhang, Taiping Wu, Wenming Zhao, Yupei |
| description | Enucleation is an effective surgical method to treat pancreatic insulinoma, however, the incidence of clinically relevant postoperative pancreatic fistula (CR-POPF) is high. We aim to investigate the risk factors for CR-POPF which have not been well characterized and develop effective methods to prevent CR-POPF after enucleation.
This retrospective cohort study included 161 patients diagnosed with insulinoma from June 2016 to July 2020 in Peking Union Medical College Hospital. The risk factors for CR-POPF were evaluated and the role of prophylactic pre-operative pancreatic stent to prevent the occurrence of CR-POPF after enucleation of pancreatic insulinoma were explored.
A cohort of 161 insulinoma cases were reviewed. The CT or MRI imaging reports could be tracked in 108 cases. A total of 96 patients underwent surgery, while 81 experienced pancreatic enucleation. Univariate and multivariate analyses showed that the distance from insulinoma to the main pancreatic duct (MPD) ≤2 mm was an independent risk factor for CR-POPF (p = 0.003, OR = 6.011, 95% Cl 1.852–19.512). The pre-operative pancreatic stent substantially reduced the incidence of CR-POPF in patients with tumor located in proximity to (distance ≤2 mm) the MPD (CR-POPF of the stented group vs the non-stented group: 37.5% vs 71.4%, p = 0.028).
The distance from insulinoma to MPD ≤2 mm is a predictive factor for CR-POPF after enucleation. Pancreatic duct stenting may benefit patients with insulinoma in proximity to the MPD by enabling a lower CR-POPF rate, so it should be considered before the enucleation of the insulinoma in proximity to the MPD (distance ≤2 mm). |
| doi_str_mv | 10.1016/j.pan.2021.06.001 |
| format | Article |
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This retrospective cohort study included 161 patients diagnosed with insulinoma from June 2016 to July 2020 in Peking Union Medical College Hospital. The risk factors for CR-POPF were evaluated and the role of prophylactic pre-operative pancreatic stent to prevent the occurrence of CR-POPF after enucleation of pancreatic insulinoma were explored.
A cohort of 161 insulinoma cases were reviewed. The CT or MRI imaging reports could be tracked in 108 cases. A total of 96 patients underwent surgery, while 81 experienced pancreatic enucleation. Univariate and multivariate analyses showed that the distance from insulinoma to the main pancreatic duct (MPD) ≤2 mm was an independent risk factor for CR-POPF (p = 0.003, OR = 6.011, 95% Cl 1.852–19.512). The pre-operative pancreatic stent substantially reduced the incidence of CR-POPF in patients with tumor located in proximity to (distance ≤2 mm) the MPD (CR-POPF of the stented group vs the non-stented group: 37.5% vs 71.4%, p = 0.028).
The distance from insulinoma to MPD ≤2 mm is a predictive factor for CR-POPF after enucleation. Pancreatic duct stenting may benefit patients with insulinoma in proximity to the MPD by enabling a lower CR-POPF rate, so it should be considered before the enucleation of the insulinoma in proximity to the MPD (distance ≤2 mm).</description><identifier>ISSN: 1424-3903</identifier><identifier>EISSN: 1424-3911</identifier><identifier>DOI: 10.1016/j.pan.2021.06.001</identifier><identifier>PMID: 34116940</identifier><language>eng</language><publisher>Switzerland: Elsevier B.V</publisher><subject>Computed tomography ; Endoscopy ; Enucleation ; Fistulae ; Implants ; Insulinoma ; Magnetic resonance imaging ; Mortality ; Neuroendocrine tumors ; Ostomy ; Pancreas ; Pancreatic duct stenting ; Pancreatic enucleation ; Patients ; Postoperative pancreatic fistula ; Prevention ; Risk factor ; Risk factors ; Surgery</subject><ispartof>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2021-09, Vol.21 (6), p.1208-1215</ispartof><rights>2021 The Authors</rights><rights>Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.</rights><rights>2021. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-835e9d3053895f64bcf0d2eeabfbd8996a3404e4413d0f06aa58f51c79ca3e5d3</citedby><cites>FETCH-LOGICAL-c424t-835e9d3053895f64bcf0d2eeabfbd8996a3404e4413d0f06aa58f51c79ca3e5d3</cites><orcidid>0000-0003-1224-6457 ; 0000-0002-4288-2481 ; 0000-0002-6785-7178</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34116940$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xu, Qiang</creatorcontrib><creatorcontrib>Xie, Qiankun</creatorcontrib><creatorcontrib>Ge, Chenghao</creatorcontrib><creatorcontrib>Zou, Xi</creatorcontrib><creatorcontrib>Gao, Ruichen</creatorcontrib><creatorcontrib>Liu, Qiaofei</creatorcontrib><creatorcontrib>Kang, Kai</creatorcontrib><creatorcontrib>Zhu, Liang</creatorcontrib><creatorcontrib>Wang, Qiang</creatorcontrib><creatorcontrib>Han, Xianlin</creatorcontrib><creatorcontrib>Liao, Quan</creatorcontrib><creatorcontrib>Dai, Menghua</creatorcontrib><creatorcontrib>Zhang, Taiping</creatorcontrib><creatorcontrib>Wu, Wenming</creatorcontrib><creatorcontrib>Zhao, Yupei</creatorcontrib><title>Risk factors and prevention of postoperative pancreatic fistula after insulinoma enucleation:a retrospective study from a high-volume center</title><title>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</title><addtitle>Pancreatology</addtitle><description>Enucleation is an effective surgical method to treat pancreatic insulinoma, however, the incidence of clinically relevant postoperative pancreatic fistula (CR-POPF) is high. We aim to investigate the risk factors for CR-POPF which have not been well characterized and develop effective methods to prevent CR-POPF after enucleation.
This retrospective cohort study included 161 patients diagnosed with insulinoma from June 2016 to July 2020 in Peking Union Medical College Hospital. The risk factors for CR-POPF were evaluated and the role of prophylactic pre-operative pancreatic stent to prevent the occurrence of CR-POPF after enucleation of pancreatic insulinoma were explored.
A cohort of 161 insulinoma cases were reviewed. The CT or MRI imaging reports could be tracked in 108 cases. A total of 96 patients underwent surgery, while 81 experienced pancreatic enucleation. Univariate and multivariate analyses showed that the distance from insulinoma to the main pancreatic duct (MPD) ≤2 mm was an independent risk factor for CR-POPF (p = 0.003, OR = 6.011, 95% Cl 1.852–19.512). The pre-operative pancreatic stent substantially reduced the incidence of CR-POPF in patients with tumor located in proximity to (distance ≤2 mm) the MPD (CR-POPF of the stented group vs the non-stented group: 37.5% vs 71.4%, p = 0.028).
The distance from insulinoma to MPD ≤2 mm is a predictive factor for CR-POPF after enucleation. Pancreatic duct stenting may benefit patients with insulinoma in proximity to the MPD by enabling a lower CR-POPF rate, so it should be considered before the enucleation of the insulinoma in proximity to the MPD (distance ≤2 mm).</description><subject>Computed tomography</subject><subject>Endoscopy</subject><subject>Enucleation</subject><subject>Fistulae</subject><subject>Implants</subject><subject>Insulinoma</subject><subject>Magnetic resonance imaging</subject><subject>Mortality</subject><subject>Neuroendocrine tumors</subject><subject>Ostomy</subject><subject>Pancreas</subject><subject>Pancreatic duct stenting</subject><subject>Pancreatic enucleation</subject><subject>Patients</subject><subject>Postoperative pancreatic fistula</subject><subject>Prevention</subject><subject>Risk factor</subject><subject>Risk factors</subject><subject>Surgery</subject><issn>1424-3903</issn><issn>1424-3911</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU9v1DAQxSMEoqXwAbggS1y4JMzEdnYDp6rin1QJCcHZ8tpj6iWxg-2s1O_Ah8bLlh44cPIcfu-N572meY7QIeDwet8tOnQ99NjB0AHgg-YcRS9aPiI-vJ-BnzVPct4D9D3i-Lg54wJxGAWcN7---PyDOW1KTJnpYNmS6ECh-BhYdGyJucSFki7-QKyuM4nqbJjzuayTZtoVSsyHvE4-xFkzCquZjkwMbzRLVFLMC5k_-iqxt8ylODPNbvz3m_YQp3UmZupGSk-bR05PmZ7dvRfNt_fvvl59bK8_f_h0dXndmnpQabdc0mg5SL4dpRvEzjiwPZHeuZ3djuOguQBBQiC34GDQWm6dRLMZjeYkLb9oXp18lxR_rpSLmn02NE06UFyz6qUAiZIPoqIv_0H3cU2h_q5SGxRiw7GvFJ4oU4_NiZxakp91ulUI6liV2quanTpWpWBQtaqqeXHnvO5msveKv91U4O0JoBrFwVNS2XgKhqxPNU9lo_-P_W_hJKdN</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Xu, Qiang</creator><creator>Xie, Qiankun</creator><creator>Ge, Chenghao</creator><creator>Zou, Xi</creator><creator>Gao, Ruichen</creator><creator>Liu, Qiaofei</creator><creator>Kang, Kai</creator><creator>Zhu, Liang</creator><creator>Wang, Qiang</creator><creator>Han, Xianlin</creator><creator>Liao, Quan</creator><creator>Dai, Menghua</creator><creator>Zhang, Taiping</creator><creator>Wu, Wenming</creator><creator>Zhao, Yupei</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1224-6457</orcidid><orcidid>https://orcid.org/0000-0002-4288-2481</orcidid><orcidid>https://orcid.org/0000-0002-6785-7178</orcidid></search><sort><creationdate>20210901</creationdate><title>Risk factors and prevention of postoperative pancreatic fistula after insulinoma enucleation:a retrospective study from a high-volume center</title><author>Xu, Qiang ; 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[et al.]</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xu, Qiang</au><au>Xie, Qiankun</au><au>Ge, Chenghao</au><au>Zou, Xi</au><au>Gao, Ruichen</au><au>Liu, Qiaofei</au><au>Kang, Kai</au><au>Zhu, Liang</au><au>Wang, Qiang</au><au>Han, Xianlin</au><au>Liao, Quan</au><au>Dai, Menghua</au><au>Zhang, Taiping</au><au>Wu, Wenming</au><au>Zhao, Yupei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors and prevention of postoperative pancreatic fistula after insulinoma enucleation:a retrospective study from a high-volume center</atitle><jtitle>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</jtitle><addtitle>Pancreatology</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>21</volume><issue>6</issue><spage>1208</spage><epage>1215</epage><pages>1208-1215</pages><issn>1424-3903</issn><eissn>1424-3911</eissn><abstract>Enucleation is an effective surgical method to treat pancreatic insulinoma, however, the incidence of clinically relevant postoperative pancreatic fistula (CR-POPF) is high. We aim to investigate the risk factors for CR-POPF which have not been well characterized and develop effective methods to prevent CR-POPF after enucleation.
This retrospective cohort study included 161 patients diagnosed with insulinoma from June 2016 to July 2020 in Peking Union Medical College Hospital. The risk factors for CR-POPF were evaluated and the role of prophylactic pre-operative pancreatic stent to prevent the occurrence of CR-POPF after enucleation of pancreatic insulinoma were explored.
A cohort of 161 insulinoma cases were reviewed. The CT or MRI imaging reports could be tracked in 108 cases. A total of 96 patients underwent surgery, while 81 experienced pancreatic enucleation. Univariate and multivariate analyses showed that the distance from insulinoma to the main pancreatic duct (MPD) ≤2 mm was an independent risk factor for CR-POPF (p = 0.003, OR = 6.011, 95% Cl 1.852–19.512). The pre-operative pancreatic stent substantially reduced the incidence of CR-POPF in patients with tumor located in proximity to (distance ≤2 mm) the MPD (CR-POPF of the stented group vs the non-stented group: 37.5% vs 71.4%, p = 0.028).
The distance from insulinoma to MPD ≤2 mm is a predictive factor for CR-POPF after enucleation. Pancreatic duct stenting may benefit patients with insulinoma in proximity to the MPD by enabling a lower CR-POPF rate, so it should be considered before the enucleation of the insulinoma in proximity to the MPD (distance ≤2 mm).</abstract><cop>Switzerland</cop><pub>Elsevier B.V</pub><pmid>34116940</pmid><doi>10.1016/j.pan.2021.06.001</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1224-6457</orcidid><orcidid>https://orcid.org/0000-0002-4288-2481</orcidid><orcidid>https://orcid.org/0000-0002-6785-7178</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Alma/SFX Local Collection |
| subjects | Computed tomography Endoscopy Enucleation Fistulae Implants Insulinoma Magnetic resonance imaging Mortality Neuroendocrine tumors Ostomy Pancreas Pancreatic duct stenting Pancreatic enucleation Patients Postoperative pancreatic fistula Prevention Risk factor Risk factors Surgery |
| title | Risk factors and prevention of postoperative pancreatic fistula after insulinoma enucleation:a retrospective study from a high-volume center |
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