Mert Guler, Omer Akay, Husnu Sevik, Ibrahim Taskin Rakici, Ceyda Turan Bektas, Rabia Kucukarslan, Mert Mahsuni Sevinc, Ufuk Oguz Idiz
{"title":"腹腔动脉狭窄对胰十二指肠切除术后胰瘘发生率的影响。","authors":"Mert Guler, Omer Akay, Husnu Sevik, Ibrahim Taskin Rakici, Ceyda Turan Bektas, Rabia Kucukarslan, Mert Mahsuni Sevinc, Ufuk Oguz Idiz","doi":"10.1177/10926429251382789","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Celiac artery stenosis (CAS) may exacerbate postoperative complications by impairing arterial perfusion in upper abdominal organs. This study evaluated the prevalence of CAS in patients undergoing pancreaticoduodenectomy and its association with clinically significant postoperative pancreatic fistula (POPF). <b><i>Methods:</i></b> A retrospective analysis of 151 patients who underwent pancreaticoduodenectomy between 2017 and 2022 was conducted. CAS was assessed via preoperative computed tomography with a stenosis threshold of ≥50%. Multivariate logistic regression identified risk factors for POPF. <b><i>Results:</i></b> CAS ≥50% was observed in 17.2% of patients, and Grade B/C POPF occurred in 17.9%. In patients with a CAS ≥50%, the risk of POPF was significantly increased (Odds Ratio: 16.458, 95% Confidence Interval: 4.575-59.203, <i>P</i> < .001). A pancreatic duct diameter of less than 3 mm and a soft pancreatic texture were found to be associated with POPF in the univariate analysis (<i>P</i> = .029, <i>P</i> = .032, respectively). Additionally, the prevalence of smoking and the median age were higher in patients with a CAS ≥50 (respectively, <i>P</i> = .011 and <i>P</i> = .052). <b><i>Conclusions:</i></b> CAS is an independent risk factor for clinically significant POPF. Preoperative CAS identification and management are vital to minimizing postoperative complications. Further studies are needed to confirm these findings.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Celiac Artery Stenosis on Pancreatic Fistula Incidence after Pancreatoduodenectomy.\",\"authors\":\"Mert Guler, Omer Akay, Husnu Sevik, Ibrahim Taskin Rakici, Ceyda Turan Bektas, Rabia Kucukarslan, Mert Mahsuni Sevinc, Ufuk Oguz Idiz\",\"doi\":\"10.1177/10926429251382789\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Introduction:</i></b> Celiac artery stenosis (CAS) may exacerbate postoperative complications by impairing arterial perfusion in upper abdominal organs. This study evaluated the prevalence of CAS in patients undergoing pancreaticoduodenectomy and its association with clinically significant postoperative pancreatic fistula (POPF). <b><i>Methods:</i></b> A retrospective analysis of 151 patients who underwent pancreaticoduodenectomy between 2017 and 2022 was conducted. CAS was assessed via preoperative computed tomography with a stenosis threshold of ≥50%. Multivariate logistic regression identified risk factors for POPF. <b><i>Results:</i></b> CAS ≥50% was observed in 17.2% of patients, and Grade B/C POPF occurred in 17.9%. In patients with a CAS ≥50%, the risk of POPF was significantly increased (Odds Ratio: 16.458, 95% Confidence Interval: 4.575-59.203, <i>P</i> < .001). A pancreatic duct diameter of less than 3 mm and a soft pancreatic texture were found to be associated with POPF in the univariate analysis (<i>P</i> = .029, <i>P</i> = .032, respectively). Additionally, the prevalence of smoking and the median age were higher in patients with a CAS ≥50 (respectively, <i>P</i> = .011 and <i>P</i> = .052). <b><i>Conclusions:</i></b> CAS is an independent risk factor for clinically significant POPF. Preoperative CAS identification and management are vital to minimizing postoperative complications. Further studies are needed to confirm these findings.</p>\",\"PeriodicalId\":50166,\"journal\":{\"name\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10926429251382789\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Laparoendoscopic & Advanced Surgical Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10926429251382789","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Impact of Celiac Artery Stenosis on Pancreatic Fistula Incidence after Pancreatoduodenectomy.
Introduction: Celiac artery stenosis (CAS) may exacerbate postoperative complications by impairing arterial perfusion in upper abdominal organs. This study evaluated the prevalence of CAS in patients undergoing pancreaticoduodenectomy and its association with clinically significant postoperative pancreatic fistula (POPF). Methods: A retrospective analysis of 151 patients who underwent pancreaticoduodenectomy between 2017 and 2022 was conducted. CAS was assessed via preoperative computed tomography with a stenosis threshold of ≥50%. Multivariate logistic regression identified risk factors for POPF. Results: CAS ≥50% was observed in 17.2% of patients, and Grade B/C POPF occurred in 17.9%. In patients with a CAS ≥50%, the risk of POPF was significantly increased (Odds Ratio: 16.458, 95% Confidence Interval: 4.575-59.203, P < .001). A pancreatic duct diameter of less than 3 mm and a soft pancreatic texture were found to be associated with POPF in the univariate analysis (P = .029, P = .032, respectively). Additionally, the prevalence of smoking and the median age were higher in patients with a CAS ≥50 (respectively, P = .011 and P = .052). Conclusions: CAS is an independent risk factor for clinically significant POPF. Preoperative CAS identification and management are vital to minimizing postoperative complications. Further studies are needed to confirm these findings.
期刊介绍:
Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.