Galchina Yu.S.1, Kondratyev E.V.1, Karmazanovsky G.G.1,2,

Gorin D.S.1, Galkin G.V.1, Kriger A.G.1

Purpose. To evaluate the possibility of computed tomography (CT) with contrast enhancement in predicting specific postoperative complications of pancreatic resections.

Materials and methods. Retrospectively selected group of patients (61). Patients were divided into 4 groups according to the structure of the pancreas, assessed qualitatively based on CT data: 1 – intact (27), 2 – fibrous (18), 3 – pancreatic lipomatosis (5), 4 – atrophy (11). Postoperative complications were identified: pancreatitis, bleeding, pancreatic fistula.

According to CT the following parameters were evaluated: pancreatic parenchyma thickness (mm), pancreatic duct diameter (mm), gland density in the native scanning phase HU (density).

The coefficients were calculated: relative arterial-to-venous enhancement (RAVE), relative parenchyma enhancement ratio (RPER), delay phase washout coefficient (DWAC) were calculated.

Results. The risk of developing pancreatitis is 2.97 times higher with a pancreatic parenchyma thickness more than 17.5 mm; 2.21 higher with a pancreatic duct diameter more than 3.25 mm; 4.24 higher with a density less than 39.5 HU; 1.64 higher with RPERven less than 0.7; 1.88 higher with a RPERdel of less than 0.6; 2.22 higher for RAVE more than 0.9; 2.47 higher with an DWAC of less than 0.43.

The risk of developing pancreatic fistula is 7.71 higher with а pancreatic duct diameter of less than 3.25; 3.08 higher with a density of less than 39.5 HU; 3.08 higher with RPERven greater than 0.54; 5.29 higher with a DWAC of more than 0.39; 5.32 higher with an RAVE of more than 0.9

The risk of bleeding is 6.17 higher with a density of less than 39.5 HU; 3.88 times higher with RPERart more than 0.47; 7.19 times higher with RPERven more than 0.51; 4.78 times higher with a RPERdel of more than 0.41.

Conclusions. CT allows to evaluate the structure of the pancreas at the preoperative period. Pancreatic parenchyma thickness, duct diameter, gland density in the native scanning phase, RPER, DWAC have the highest predictive value of postoperative complications.


1 - A.V. Vishnevsky National Medical Research Center of Surgery.

2 - N.I. Pirogov Russian National Research Medical University.

Moscow, Russia.

Keywords: computed tomography with contrast enhancement, complications, pancreatoduodenal resection, pancreatic fistula, pancreatitis, bleeding, density, predictors.


Corresponding author:  Galchina Yu. S., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Galchina Yu.S., Kondratyev E.V., Karmazanovsky G.G., Gorin D.S., Galkin G.V., Kriger A.G. CT predictors of postoperative specific complications in pancreatic resections. REJR 2020; 10(2):102-115. DOI:10.21569/2222-7415-2020-10-2-102-115.


Received:       03.02.20 Accepted: 17.06.20