Abstract

Background: Pancreatic fistula is one of the most dreadful complication of pancreatoduodenectomy causing prolonged hospital stay, financial implications and mortality. The aim of the present study was to assess remnant pancreatic volume based on preoperative CECT and to validate it for predicting pancreatic fistula.
Methods: 52 patients undergoing pancreatodudenectomy in which pancreatic protocol CECT was done in the hospital were included, Remnant pancreatic volume was calculated from the CT as the sum of pancreatic tissue area to the left of the presumed pancreatic transection site and its correlation to postoperative pancreatic fistula was done.
Results: n= 9(17.2%) patients had clinically relevant fistula, mean remnant pancreatic volume in patients without fistula was 36.86±10.73 cm3 and those with clinically relevant fistula was 58.03±12.33 cm3 (p value= <.001), on ROC curve analysis remnant pancreatic volume of >48.6 cm3 was found to be 88.8% sensitive and 76% sensitive in predicting clinically significant pancreatic fistula.
Conclusion: Preoperative assessment of remnant pancreatic volume is a useful marker for predicting postoperative pancreatic fistula and may help in better application of preventive measures in high risk group in future.