ULTRASOUND ELASTOMETRY OF THE PANCREAS IN A DIFFERENTIATED APPROACH TO THE FORMATION OF PANCREATOENTEROANASTOMOSIS IN PANCREATODUODENAL RESECTION

Abstract

Aim. This study was conducted to assess the possibility of ultrasound elastometry using the shear wave method in the preoperative assessment of the stiffness condition of the pancreatic parenchyma in order to predict the risk of complications and the choice of the method for the formation of pancreatoenteroanastomosis in pancreatoduodenal resection.Materials and methods. The study was performed in 10 patients operated in the volume of pancreatoduodenal resection. All patients underwent preoperative ultrasound pancreatic elastometry with transcutaneous shear wave access method. The results were compared with the intraoperative data obtained by the visual examination and palpation. Depending on the average "stiffness" indicators of the parenchyma in comparison with the intraoperative data, one of two ways of forming the pancreatic intestinal anastomosis was preferred: either end-to-side or pancreatoenteroanastomosis with a wide atraumatic peritonization of the pancreas stump cutoff by the jejunum according to the original technique.Results. The inconsistency of class A pancreatoenteroanastomosis was noted in 2 (20%) patients, it was transient, asymptomatic, did not require additional medical interventions and did not extend the duration of the postoperative period. There were no inconsistencies of classes B and C, pancreonecrosis of the stump, repeated surgical interventions, and lethal outcomes.Conclusion. Ultrasound pancreatic elastometry with the shear wave method can be used in the preoperative assessment of the "stiffness" of the parenchyma in order to predict the risk of the complications and the choice of the method for the pancreatoenteroanastomosis formation.

Keywords

• pancreatic cancer
• pancreatoduodenal resection
• pancreatodigestive anastomosis
• ultrasound elastometry