{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:05:30Z","timestamp":1787893530634,"version":"build-2784847793"},"reference-count":40,"publisher":"Korean Society of Ultrasound in Medicine","issue":"4","license":[{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-ultrasonography.org"],"crossmark-restriction":true},"short-container-title":["Ultrasonography"],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:p>Purpose: This study aimed to evaluate the effectiveness of using the severity of hyperechoic pancreas (HP) observed on preoperative ultrasonography (US) as a predictor of clinically relevant postoperative pancreatic fistula (CR-POPF).Methods: A retrospective study was conducted with 94 patients who underwent pancreatectomy between April 2006 and March 2021. The severity of HP on US was classified into two categories (normal to mild vs. moderate to severe [obvious HP]). Multiple preoperative and intraoperative parameters were analyzed to predict CR-POPF.Results: Out of the 94 patients, CR-POPF occurred in 21 (22%) patients, and obvious HP was observed in 30 (32%). Univariate analysis revealed that moderate to severe HP (obvious HP) was significantly associated with an increased incidence of CR-POPF (P&amp;lt;0.001). Factors such as the absence of pancreatitis, a small main pancreatic duct (&amp;lt;3 mm), intraoperative soft pancreas, increased body mass index, and lower pancreatic attenuation and attenuation index were also associated with CR-POPF (all P&amp;lt;0.05). Multivariate analysis showed that obvious HP and soft pancreatic texture were independent predictors of CR-POPF, with odds ratios of 11.53 (P=0.001) and 14.12 (P=0.003), respectively. The combination of obvious HP and soft pancreatic texture provided the most accurate prediction for CR-POPF.Conclusion: The severity of HP, as observed on preoperative US, was significantly associated with CR-POPF. Severe HP may serve as a clinically useful predictor of POPF, especially when evaluated alongside the intraoperative pancreatic texture.<\/jats:p>","DOI":"10.14366\/usg.24046","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T06:26:36Z","timestamp":1716963996000},"page":"272-283","update-policy":"https:\/\/doi.org\/10.14366\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Severity of hyperechoic pancreas on preoperative ultrasonography: high potential as a clinically useful predictor of a postoperative pancreatic fistula"],"prefix":"10.14366","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1849-6679","authenticated-orcid":true,"given":"Jung Joo","family":"Hong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1701-0478","authenticated-orcid":true,"given":"Hyun Jeong","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0780-7985","authenticated-orcid":true,"given":"Eun Sun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5431-6321","authenticated-orcid":true,"given":"Min Ju","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5473","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14891"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2013.04.322"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.09.002"},{"key":"ref4","first-page":"932","volume-title":"Measurement of pancreatic fat by magnetic resonance imaging: predicting the occurrence of pancreatic fistula after pancreatoduodenectomy","author":"Lee","year":"2010"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2019.05.008"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2016.06.108"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0b013e318256c32c"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-015-2855-7"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015142254"},{"key":"ref10","first-page":"512","volume-title":"Prediction of pancreatic anastomotic failure after pancreatoduodenectomy: the use of preoperative, quantitative computed tomography to measure remnant pancreatic volume and body composition","author":"Kirihara","year":"2013"},{"key":"ref11","first-page":"937","volume-title":"Alternative Fistula Risk Score for Pancreatoduodenectomy (a-FRS): design and international external validation","author":"Mungroop","year":"2019"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i34.4329"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.139.6.1095"},{"key":"ref14","first-page":"1058","volume-title":"Fatty pancreas: a factor in postoperative pancreatic fistula","author":"Mathur","year":"2007"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.07.940"},{"key":"ref16","first-page":"781","volume-title":"Prediction of postoperative pancreatic fistulas after pancreatectomy: assessment with acoustic radiation force impulse elastography","author":"Lee","year":"2014"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.11529"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1159\/000477475"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.12.005"},{"key":"ref20","first-page":"419","volume-title":"Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? 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