Value of real-time elastography in predicting the risk of pancreatic fistula after pancreaticoduodenectomy

Objective Objective To investigate the value of pancreatic elasticity based on shear wave elastography ( SWE) in predicting the risk of pancreatic fistula, to measure pancreatic hardness by determining the SWE level of the pancreatic body, and to reduce the development of pancreatic fistula after pancreaticoduodenectomy. Methods A retrospective analysis was performed for the clinical data of 53 patients who were admitted to The Affiliated Hospital of Binzhou Medical University from October 2017 to February 2019 and underwent pancreaticoduodenectomy ( PD) . The 53 patients were divided into pancreatic fistula group with 10 patients who developed pancreatic fistula after PD and non-pancreatic fistula group with 43 patients who did not develop this disease after PD. The elasticity value of the pancreatic body measured by SWE was used to reflect the tissue elasticity of the pancreas and evaluate the hardness of the pancreas. The t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between groups. A logistic regression analysis was used for univariate analysis, and the Spearman's correlation coefficient was used to investigate the correlation between SWE and other laboratory data. Results Body mass index ( BMI) ( t = 1. 321) , preoperative total bilirubin ( t = 1. 347) , diameter of the main pancreatic duct ( t = 1. 385) , maximum SWE value ( t = 1. 728) , mean SWE value ( t = 1. 634) , and intraoperative pancreatic hardness ( χ2= 4. 983) were risk factors for pancreatic fistula ( all P < 0. 05) . Maximum SWE value and mean SWE value were negatively correlated with age and time of operation ( maximum SWE value: r =-0. 329 and-0. 260, both P < 0. 05; mean SWE value: r =-0. 282, and-0. 282, both P < 0. 05) and positively correlated with BMI ( r = 0. 275 and 0. 350, both P < 0. 05) . Conclusion SWE level is an independent risk factor for pancreatic fistula after pancreaticoduodenectomy, and the SWE level of the pancreatic body has a high predictive value and guiding significance in surgical treatment.