The pancreatic fistula paradox in pancreatic cancer patients undergoing pancreatectomy

Key clinical point: Among patients with pancreatic cancer undergoing pancreatectomy, pancreatic fistula (PF) did not affect postoperative pancreatic exocrine function. However, preserved or accelerated exocrine function post-pancreatectomy may cause PF.

Major finding: The levels of ¹³C-trioctanoin absorption (%dose/hour) post- vs. preoperation decreased significantly in the non-PF group (28.5 vs. 36.5; P < .0001) but did not change in the PF group (36.9 vs. 34.5; P = .129). Higher postoperative ¹³C-trioctanoin absorption was independently associated with PF (adjusted odds ratio 1.156; P = .001). Patients with ¹³C-trioctanoin absorption (%dose/hour) of ≥30 vs. <30 had higher postoperative maximum drain amylase levels (2,502 U/L vs. 398 U/L; P = .001).

Study details: This retrospective study included 96 patients with (n = 17) or without (n = 79) PF who underwent ¹³C-trioctanoin breath tests before and approximately 1 month after pancreatectomy.

Disclosures: No source of funding was identified. The authors declared no conflict of interests.

Source: Higashiguchi T et al. Surg Today. 2021 Sep 16. doi: 10.1007/s00595-021-02371-w.

Key clinical point: Among patients with pancreatic cancer undergoing pancreatectomy, pancreatic fistula (PF) did not affect postoperative pancreatic exocrine function. However, preserved or accelerated exocrine function post-pancreatectomy may cause PF.

Major finding: The levels of ¹³C-trioctanoin absorption (%dose/hour) post- vs. preoperation decreased significantly in the non-PF group (28.5 vs. 36.5; P < .0001) but did not change in the PF group (36.9 vs. 34.5; P = .129). Higher postoperative ¹³C-trioctanoin absorption was independently associated with PF (adjusted odds ratio 1.156; P = .001). Patients with ¹³C-trioctanoin absorption (%dose/hour) of ≥30 vs. <30 had higher postoperative maximum drain amylase levels (2,502 U/L vs. 398 U/L; P = .001).

Study details: This retrospective study included 96 patients with (n = 17) or without (n = 79) PF who underwent ¹³C-trioctanoin breath tests before and approximately 1 month after pancreatectomy.

Disclosures: No source of funding was identified. The authors declared no conflict of interests.

Source: Higashiguchi T et al. Surg Today. 2021 Sep 16. doi: 10.1007/s00595-021-02371-w.

Key clinical point: Among patients with pancreatic cancer undergoing pancreatectomy, pancreatic fistula (PF) did not affect postoperative pancreatic exocrine function. However, preserved or accelerated exocrine function post-pancreatectomy may cause PF.

Major finding: The levels of ¹³C-trioctanoin absorption (%dose/hour) post- vs. preoperation decreased significantly in the non-PF group (28.5 vs. 36.5; P < .0001) but did not change in the PF group (36.9 vs. 34.5; P = .129). Higher postoperative ¹³C-trioctanoin absorption was independently associated with PF (adjusted odds ratio 1.156; P = .001). Patients with ¹³C-trioctanoin absorption (%dose/hour) of ≥30 vs. <30 had higher postoperative maximum drain amylase levels (2,502 U/L vs. 398 U/L; P = .001).

Study details: This retrospective study included 96 patients with (n = 17) or without (n = 79) PF who underwent ¹³C-trioctanoin breath tests before and approximately 1 month after pancreatectomy.

Disclosures: No source of funding was identified. The authors declared no conflict of interests.

Source: Higashiguchi T et al. Surg Today. 2021 Sep 16. doi: 10.1007/s00595-021-02371-w.