Scholarlink

Background <p>Clinically relevant postoperative pancreatic fistula (CR-POPF) is the most consequential complication after distal pancreatectomy, occurring in up to one-third of cases. Video-based assessment (VBA) captures technical details not documented in operative reports. We conducted a VBA study to evaluate intraoperative factors associated with CR-POPF.</p> Methods <p>We performed a retrospective single-center study of adults undergoing laparoscopic or robotic distal pancreatectomy (2019–2024). Three blinded reviewers coded predefined intraoperative variables from operative videos during the pancreatic&#xa0;transection. Associations with CR-POPF were assessed using Firth penalized logistic regression.</p> Results <p>Among 43 patients, 11 (25.6%) developed CR-POPF. Patients with CR-POPF were younger (median 46 vs. 59&#xa0;years, <i>p</i> &lt; 0.05) and more often non-white (27% vs. 63%, <i>p</i> &lt; 0.05). Intraoperatively, coarse stapler movement (73% vs. 25%, <i>p</i> &lt; 0.05) and capsular fracture (73% vs. 19%, <i>p</i> &lt; 0.05) were significantly associated with CR-POPF. Rotational movement, short compression time, and stapler line bleeding trended toward significance. Clip application for hemostasis showed a non-significant protective effect. On regression analysis, capsular fracture predicted CR-POPF (OR = 6.47, <i>p</i> = 0.03), and coarse stapler movement trended toward significance (OR = 9.22, <i>p</i> = 0.06).</p> Conclusion <p>VBA identified capsular fracture as a significant predictor of CR-POPF and stapler movement as a modifiable factor. Larger multicenter studies are warranted to validate findings and guide technical training.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Video-based assessment identifies intraoperative predictors of clinically relevant POPF following minimally invasive distal pancreatectomy

  • 期刊论文

  • 发表日期：

    2026年5月22日

查看全文
  • Laleh Foroutani,
  • Pietro Mascagni,
  • Amir Ashraf Ganjouei,
  • Nora Fotoohi,
  • Eric K. Nakakura,
  • Carlos Corvera,
  • Mohamed Abdelgadir Adam,
  • Adnan A. Alseidi

摘要

Background

Clinically relevant postoperative pancreatic fistula (CR-POPF) is the most consequential complication after distal pancreatectomy, occurring in up to one-third of cases. Video-based assessment (VBA) captures technical details not documented in operative reports. We conducted a VBA study to evaluate intraoperative factors associated with CR-POPF.

Methods

We performed a retrospective single-center study of adults undergoing laparoscopic or robotic distal pancreatectomy (2019–2024). Three blinded reviewers coded predefined intraoperative variables from operative videos during the pancreatic transection. Associations with CR-POPF were assessed using Firth penalized logistic regression.

Results

Among 43 patients, 11 (25.6%) developed CR-POPF. Patients with CR-POPF were younger (median 46 vs. 59 years, p < 0.05) and more often non-white (27% vs. 63%, p < 0.05). Intraoperatively, coarse stapler movement (73% vs. 25%, p < 0.05) and capsular fracture (73% vs. 19%, p < 0.05) were significantly associated with CR-POPF. Rotational movement, short compression time, and stapler line bleeding trended toward significance. Clip application for hemostasis showed a non-significant protective effect. On regression analysis, capsular fracture predicted CR-POPF (OR = 6.47, p = 0.03), and coarse stapler movement trended toward significance (OR = 9.22, p = 0.06).

Conclusion

VBA identified capsular fracture as a significant predictor of CR-POPF and stapler movement as a modifiable factor. Larger multicenter studies are warranted to validate findings and guide technical training.