{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:12:44Z","timestamp":1780107164848,"version":"3.54.0"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T00:00:00Z","timestamp":1497225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T00:00:00Z","timestamp":1497225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pancreatic texture is one of the key predictors of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). Currently, the \u201cgold standard\u201d for assessment of pancreatic texture is surgeon\u2019s subjective evaluation through manual palpation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate a new \u201cdurometer\u201d that is able to assess quantitatively the pancreatic stiffness by measuring its elastic module (i.e., the resistance offered by the pancreatic stump when elastically deformed expressed in mPa).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Measurements were obtained from the pancreatic remnant during 138 consecutive PDs performed at the Department of General and Pancreatic Surgery\u2014The Pancreas Institute, University of Verona Hospital Trust. Values were correlated to clinical features and, in particular, with the senior surgeon\u2019s evaluation of pancreatic texture (hard\/soft). Sixteen beating\u2010heart donors were used as a control group to assess the stiffness of a non\u2010pathologic pancreas. Univariate analysis was performed for the assessment of POPF predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Durometry allowed segregating between non\u2010pathologic, soft and hard pancreas according to surgeon\u2019s evaluation (mean values 111 vs. 196 vs. 366\u00a0mPa, <jats:italic>p<\/jats:italic> &lt; 0.01). There were no significant differences in stiffness with regard to histology, BMI, and neoadjuvant therapy. Larger tumors (&gt;20\u00a0mm) and male sex were associated with greater stiffness on univariate analysis. Pancreatic texture, pancreatic duct size, BMI, prior neoadjuvant therapy, and histology were predictors of POPF. Patients who developed POPF showed a lesser stiffness (178 vs. 261\u00a0mPa, <jats:italic>p<\/jats:italic> = 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Assessment of pancreatic stiffness using a durometer correlated with the surgeon\u2019s evaluation of pancreatic texture. Measurement of pancreatic parenchymal stiffness is reliable and correlates with the development of POPF.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4073-9","type":"journal-article","created":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T16:17:41Z","timestamp":1497284261000},"page":"2876-2883","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Quantitative Assessment of Pancreatic Texture Using a Durometer: A New Tool to Predict the Risk of Developing a Postoperative Fistula"],"prefix":"10.1002","volume":"41","author":[{"given":"Giovanni","family":"Marchegiani","sequence":"first","affiliation":[{"name":"Department of Surgery and Oncology, General and Pancreatic Surgery \u2010 The Pancreas Institute University of Verona Hospital Trust P.le Scuro 10 37134 Verona 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