Prediction of postoperative pancreatic fistulas after pancreatectomy: Assessment with acoustic radiation force impulse elastography

Tae Kil Lee, Chang Moo Kang, Mi Suk Park, Sung Hoon Choi, Yong Eun Chung, Jin Young Choi, Myeong Jin Kim

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


Objectives: The purpose of this prospective study was to investigate the usefulness of acoustic radiation force impulse (ARFI) elastography of the pancreas for predicting postoperative pancreatic fistula occurrence after pancreatic resection. Methods-Twenty-five patients underwent ARFI elastography of the pancreas before pancreatic resection (11 men and 14 women; mean age, 59.1 years; range, 28-76 years). In each patient, 3 valid ARFI measurements (meters per second) were performed at the head of the pancreas, and the median values were calculated. Patients underwent pancreaticoduodenectomy (n = 18) or distal pancreatectomy (n = 7). Clinically relevant fistulas (grade B or higher) were determined according to the standard criteria used by the International Study Group on Pancreatic Fistula. Preoperative ARFI values were compared between the fistula and nonfistula groups (Mann-Whitney test). Results: Clinically relevant fistulas (grade B or higher) were observed in 8 patients (32%; fistula group), including 5 of 18 patients with pancreaticoduodenectomy (28%) and 3 of 7 patients with distal pancreatectomy (43%). The ARFI values in the fistula group (median, 1.45 m/s; range, 0.80-1.98 m/s) were lower than in the nonfistula group (median, 1.54 m/s; range, 0.98-3.40 m/s), but there was no statistical significance (P =.1374). When confining the results to only patients with pancreaticoduodenectomy, the ARFI values were significantly lower in the patients with fistulas (median, 0.98 m/s; range, 0.80-1.94 m/s) than in those without fistulas (median, 1.60 m/s; range, 1.08-3.40 m/s; P =.0460). Conclusions: This preliminary study showed the potential feasibility of a clinical application of ARFI elastography in preoperatively predicting postoperative pancreatic fistulas after pancreaticoduodenectomy. Investigation of this method in larger studies is needed.

Original languageEnglish
Pages (from-to)781-786
Number of pages6
JournalJournal of Ultrasound in Medicine
Issue number5
Publication statusPublished - 2014 May 1

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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