{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T12:01:36Z","timestamp":1772366496692,"version":"3.50.1"},"reference-count":10,"publisher":"International College of Surgeons","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:p>\u201cSoft pancreas\u201d has often been reported as a predictive factor for postoperative pancreatic fistula (POPF) after pancreatectomy. However, pancreatic stiffness is judged subjectively by surgeons, without objective criteria. In the present study, pancreatic stiffness was quantified using intraoperative ultrasound elastography, and its relevance to POPF and histopathology was investigated. Forty-one patients (pancreatoduodenectomy, 30; distal pancreatectomy, 11) who underwent intraoperative elastography during pancreatectomy were included. The elastic ratio was determined at the pancreatic resection site (just above the portal vein) and at the remnant pancreas (head or tail). Correlations between the incidence of POPF and patient characteristics, operative variables, and the elastic ratio were examined. In addition, the relationship between the elastic ratio and the percentage of the exocrine gland at the resection stump was investigated. For pancreatoduodenectomy patients, main pancreatic duct diameter &lt; 3.2 mm and elastic ratio &lt; 2.09 were significant risk factors for POPF. In addition, the elastic ratio, but not main pancreatic duct diameter, was significantly associated with the percentage of exocrine gland area at the pancreatic resection stump. Pancreatic stiffness can be quantified using intraoperative elastography. Elastography can be used to diagnose \u201csoft pancreas\u201d and may thus be useful in predicting the occurrence of POPF.<\/jats:p>","DOI":"10.9738\/intsurg-d-14-00040.1","type":"journal-article","created":{"date-parts":[[2015,3,18]],"date-time":"2015-03-18T22:39:23Z","timestamp":1426718363000},"page":"497-502","source":"Crossref","is-referenced-by-count":30,"title":["Quantification of Pancreatic Stiffness on Intraoperative Ultrasound Elastography and Evaluation of its Relationship With Postoperative Pancreatic Fistula"],"prefix":"10.9738","volume":"100","author":[{"given":"Masahide","family":"Hatano","sequence":"first","affiliation":[{"name":"Department of Hepato-Biliary-Pancreatic Surgery and Breast Surgery, Graduate School of Medicine, Ehime University, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jota","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Hepato-Biliary-Pancreatic Surgery and Breast Surgery, Graduate School of Medicine, Ehime University, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiki","family":"Kushihata","sequence":"additional","affiliation":[{"name":"Department of Hepato-Biliary-Pancreatic Surgery and Breast Surgery, Graduate School of Medicine, Ehime University, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taiji","family":"Tohyama","sequence":"additional","affiliation":[{"name":"Department of Hepato-Biliary-Pancreatic Surgery and Breast Surgery, Graduate School of Medicine, Ehime University, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taira","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology, Graduate School of Medicine, Ehime University, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuhito","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology, Graduate School of Medicine, Ehime University, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teru","family":"Kumagi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology, Graduate School of Medicine, Ehime University, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiko","family":"Hisano","sequence":"additional","affiliation":[{"name":"Pathology Division, Ehime University Hospital, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuro","family":"Sugita","sequence":"additional","affiliation":[{"name":"Pathology Division, Ehime University Hospital, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasutsugu","family":"Takada","sequence":"additional","affiliation":[{"name":"Department of Hepato-Biliary-Pancreatic Surgery and Breast Surgery, Graduate School of Medicine, Ehime University, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"9","key":"i0020-8868-100-3-497-b01","series-title":"J Gastrointest Surg","first-page":"1199","article-title":"1423 pancreaticoduodenectomies for pancreatic cancer: a single-institution experience","volume":"10","author":"Winter\n              JM,","year":"2006","unstructured":"Winter\n              JM, \n            \n              Cameron\n              JL, \n            \n              Campbell\n              KA, \n            \n              Arnold\n              MA, \n            \n              Chang\n              DC, \n            \n              Coleman\n              J\n            \n            et al\n          . 1423 pancreaticoduodenectomies for pancreatic cancer: a single-institution experience. J Gastrointest Surg2006;10(9):1199\u20131210"},{"issue":"12","key":"i0020-8868-100-3-497-b02","series-title":"J Gastrointest Surg","first-page":"2187","article-title":"Clinical validation of the ISGPF classification and the risk factor of pancreatic fistula formation following duct-to-mucosa pancreaticojejunostomy by one surgeon at a single center","volume":"15","author":"Kim\n              WS,","year":"2011","unstructured":"Kim\n              WS, \n            \n              Choi\n              DW, \n            \n              Choi\n              SH, \n            \n              Heo\n              JS, \n            \n              Kim\n              MJ, \n            \n              Song\n              SC\n            \n            et al\n          . Clinical validation of the ISGPF classification and the risk factor of pancreatic fistula formation following duct-to-mucosa pancreaticojejunostomy by one surgeon at a single center. 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Hepatology2012;56(4):1271\u20131278"},{"issue":"1","key":"i0020-8868-100-3-497-b07","series-title":"Pancreas","first-page":"17","article-title":"Feasibility of tissue elastography using transcutaneous ultrasonography for the diagnosis of pancreatic diseases","volume":"38","author":"Uchida\n              H,","year":"2009","unstructured":"Uchida\n              H, \n            \n              Hirooka\n              Y, \n            \n              Itoh\n              A, \n            \n              Kawashima\n              H, \n            \n              Hara\n              K, \n            \n              Nonogaki\n              K\n            \n            et al\n          . Feasibility of tissue elastography using transcutaneous ultrasonography for the diagnosis of pancreatic diseases. 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Surgery2010;148(1):15\u201323"}],"container-title":["International Surgery"],"original-title":[],"link":[{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/100\/3\/article-p497.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/international-surgery\/article-pdf\/100\/3\/497\/2206362\/intsurg-d-14-00040_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/100\/3\/article-p497.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/100\/3\/article-p497.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T19:05:51Z","timestamp":1751483151000},"score":1,"resource":{"primary":{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/100\/3\/article-p497.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":10,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.9738\/intsurg-d-14-00040.1","relation":{},"ISSN":["0020-8868","2520-2456"],"issn-type":[{"value":"0020-8868","type":"print"},{"value":"2520-2456","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3]]}}}