Methods
Statisitcal analysis of the data
Pentru descrierea variabilelor cantitative am folosit histograme și am calculat mediile aritmetice ± deviația standard (DS) [cu intervalul de încredere (IC) 95%], precum și valorile extreme și mediane. Pentru variabilele calitative, am folosit pie-uri sau bar-chart-uri și am calculat frecvențele absolute și relative ale categoriilor formate.
Pentru a studia relațiile dintre variabilele cantitative și cele calitative, am folosit testele T și Mann-Whitney (MW) dacă acestea au fost binare, respectiv ANOVA dacă acestea au avut mai multe categorii. Am prezentat valorile p generate de aceste teste precum și mediile ± DS ale grupurilor și diferența mediilor cu IC95% asociat. Am prezentat grafic rezultatele sub forma unor box-plot-uri. Pentru a studia relațiile dintre variabilele cantitative am folosit coeficientul de corelație Spearman (R), cu valoarea p asociata și am prezentat grafic relațiile sub forma unor scatter-plot-uri pe care am adăugat linia de regresie cu IC95%. Pentru a descrie relațiile dintre variabilele calitative am folosit testul Chi2 sau Fisher și indicatorii Cramer phi sau V și Odds-Ratio (OR) / Risc relativ (RR) cu IC95%. Am prezentat grafic rezultatele sub forma unor bar-chart-uri.
Am folosit Microsot Excel 2016 pentru managementul bazei de date. Pentru toate analizele statistice și graficele ulterioare am folosit R 3.6.1 [1]. Am considerat p < 0.05 ca fiind semnificativ statistic și p < 0.1 ca prezentând doar o tendință spre semnificativitate statistică.
Results
Main
Table 1: Demographic parameters of the sample.
Variable | Details | Total |
N= |
| 231 |
Age (years) | μ ±SD | 62.83 ±9.51 |
M (min:max) | 63.25 (21.94:87.33) |
Sex | F | 94 (40.7%) |
M | 137 (59.3%) |
Alive at 1-Oct-2019 | 95 (41.1%) |
Place of living | rural | 72 (34.8%) |
urban | 135 (65.2%) |
State at discharge | cured | 53 (24.7%) |
ameliorated | 145 (67.4%) |
stationary | 1 (0.5%) |
agravated | 4 (1.9%) |
deceased | 12 (5.6%) |
Family history of cancer | 10 (4.3%) |
Survival time (years) | μ ±SD | 2.40 ±1.77 |
M (min:max) | 2.02 (0:6.61) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Figure 1: Sex and place of living distribution.
Figure 2: Age distribution, at admission, colored by sex. (| media, ¦ mediana).
Figure 1: Sex and place of living distribution.
Figure 2: Age distribution, at admission, colored by sex. (| media, ¦ mediana).
Address
Figure 3: Distribuția geografică a cazurilor
Dates
Laboratory
Table 3: Laboratory parameters of the sample.
Variable | Details | Total |
N= |
| 231 |
Hemoglobin (mg/dL) | μ ±SD | 11.75 ±2.32 |
M (min:max) | 11.7 (7.96:16.4) |
Leucocytes (*10³/µL) | μ ±SD | 10.93 ±5.99 |
M (min:max) | 8.64 (3.32:32.3) |
Platelets (*10³/µL) | μ ±SD | 281.55 ±102.6 |
M (min:max) | 287.5 (74:595) |
Sodium (mEq/L) | μ ±SD | 142.59 ±3.5 |
M (min:max) | 142 (131:160) |
Potassium (mEq/L) | μ ±SD | 5.02 ±0.768 |
M (min:max) | 4.8 (3.6:8.8) |
Calcium (mEq/L) | μ ±SD | 4.62 ±0.382 |
M (min:max) | 4.65 (3.13:5.61) |
AST (IU/L) | μ ±SD | 83.80 ±99.1 |
M (min:max) | 70.5 (8:886) |
ALT (IU/L) | μ ±SD | 113.90 ±168.0 |
M (min:max) | 78.5 (6:987) |
Total bilirubin (mg/dL) | μ ±SD | 4.30 ±3.48 |
M (min:max) | 3.1 (0.3:18.5) |
Direct bilirubin (mg/dL) | μ ±SD | 3.79 ±3.39 |
M (min:max) | 2.56 (0.14:14.04) |
Alkaline phosphatase (IU/L) | μ ±SD | 655.57 ±443.9 |
M (min:max) | 672 (69:4086) |
Gamma-GT (IU/L) | μ ±SD | 376.90 ±410.1 |
M (min:max) | 99 (7:3109) |
Blood amylase (IU/L) | μ ±SD | 112.75 ±185.8 |
M (min:max) | 71.5 (2:965) |
Urine amylase (IU/L) | μ ±SD | 2891.77 ±6393.3 |
M (min:max) | 66.5 (1:37578) |
Urea (mg/dL) | μ ±SD | 52.73 ±21.7 |
M (min:max) | 51 (6:99) |
Creatinine (mg/dL) | μ ±SD | 1.13 ±0.841 |
M (min:max) | 0.88 (0.36:8.93) |
Total protein (mg/dL) | μ ±SD | 7.08 ±0.949 |
M (min:max) | 7.2 (4.3:9.7) |
Prothrombin time (sec) | μ ±SD | 24.29 ±8.12 |
M (min:max) | 22.8 (14.5:76.7) |
APTT (sec) | μ ±SD | 51.98 ±27.1 |
M (min:max) | 47.25 (23.2:83.7) |
INR | μ ±SD | 1.65 ±0.712 |
M (min:max) | 1.5 (0.96:7.85) |
CA 19-9 (ng/mL) | μ ±SD | 205.61 ±598.7 |
M (min:max) | 63.95 (1:5610) |
ACE (ng/mL) | μ ±SD | 10.55 ±23.0 |
M (min:max) | 4 (0.9:121) |
AFP (ng/mL) | μ ±SD | 102.23 ±198.5 |
M (min:max) | 3.7 (1.53:400) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Figure 19: Laboratory paramenters.
Time to normalization
Table 4: Time to normalization parameters of the sample.
Variable | Details | Total |
N= |
| 231 |
Transit restart (days) | μ ±SD | 3.32 ±0.939 |
M (min:max) | 3 (1:7) |
Mobilization (days) | μ ±SD | 1.85 ±0.885 |
M (min:max) | 2 (1:6) |
Liquid alimentation restart (days) | μ ±SD | 2.00 ±1.11 |
M (min:max) | 2 (1:7) |
Solid alimentation restart (days) | μ ±SD | 3.46 ±1.32 |
M (min:max) | 3 (1:10) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Figure 20: Time to normalization, by sex.
Yes/No
Symptoms
Figure 21: Distribution of patients with any of the listed Symptoms.
Table 5: Distribution of patients with any of the listed Symptoms.
Variable | Total |
N= | 231 |
Pain | 120 (51.9%) |
Nausea | 70 (30.3%) |
Vomit | 50 (21.6%) |
Fatigability | 85 (36.8%) |
Asthenia | 119 (51.5%) |
Fever | 10 (4.3%) |
Loss of appetite | 225 (97.4%) |
Weight loss | 153 (66.2%) |
Diarrhea | 13 (5.6%) |
Melaena | 4 (1.7%) |
Hematemesis | 0 |
None | 9 (3.9%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Signs
Figure 22: Distribution of patients with any of the listed Signs.
Table 6: Distribution of patients with any of the listed Signs.
Variable | Total |
N= | 231 |
Jaundice | 167 (72.3%) |
Hepatomegaly | 8 (3.5%) |
Courvoisier-Terrier | 12 (5.2%) |
Ascites | 2 (0.9%) |
Palpable tumor | 1 (0.4%) |
Phlebitis migrans (Trousseau sign?) | 0 |
Ileus | 0 |
Splenomegaly | 0 |
Ecchymosis | 0 |
None | 32 (13.9%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Comorbidities
Figure 23: Distribution of patients with any of the listed Comorbidities.
Table 7: Distribution of patients with any of the listed Comorbidities.
Variable | Total |
N= | 231 |
None / irrelevant | 45 (19.5%) |
Diabetes mellitus | 45 (19.5%) |
Vesicular lithiasis | 30 (13.0%) |
Cardio-vascular disease | 99 (42.9%) |
Lung disease | 16 (6.9%) |
Liver disease | 18 (7.8%) |
Kidney disease | 10 (4.3%) |
Cancer | 11 (4.8%) |
Others | 43 (18.6%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Toxics
Figure 24: Distribution of patients with any of the listed Toxics.
Table 8: Distribution of patients with any of the listed Toxics.
Variable | Total |
N= | 231 |
None / deny | 141 (61.0%) |
Alcohol | 53 (22.9%) |
Smoking | 44 (19.0%) |
Nitrosamines | 0 |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Ultrasound
Figure 25: Distribution of patients with any of the listed Ultrasound.
Table 9: Distribution of patients with any of the listed Ultrasound.
Variable | Total |
N= | 231 |
Veins invasion | 3 (1.3%) |
Arteries invasion | 1 (0.4%) |
Gut invasion | 4 (1.7%) |
Tumor < 4 cm | 94 (40.7%) |
Lymphadenopathy | 26 (11.3%) |
Liver metastases | 0 |
Peritoneal metastases | 0 |
Ascites | 1 (0.4%) |
Dilated bile ducts | 80 (34.6%) |
Inhomogeneous pancreas | 26 (11.3%) |
Fluid sequestration | 0 |
Abscesses | 0 |
Pancreatic fluid collections | 0 |
Wirsung lithiasis | 0 |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Abdominal CT
Figure 26: Distribution of patients with any of the listed Abdominal CT.
Table 10: Distribution of patients with any of the listed Abdominal CT.
Variable | Total |
N= | 231 |
Veins invasion | 10 (4.3%) |
Arteries invasion | 3 (1.3%) |
Gut invasion | 6 (2.6%) |
Tumor < 4 cm | 104 (45.0%) |
Lymphadenopathy | 57 (24.7%) |
Liver metastases | 1 (0.4%) |
Peritoneal metastases | 0 |
Ascites | 2 (0.9%) |
Dilated bile ducts | 81 (35.1%) |
Inhomogeneous pancreas | 35 (15.2%) |
Fluid sequestration | 0 |
Abscesses | 1 (0.4%) |
Pancreatic fluid collections | 0 |
Wirsung lithiasis | 0 |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
MRI
Figure 27: Distribution of patients with any of the listed MRI.
Table 11: Distribution of patients with any of the listed MRI.
Variable | Total |
N= | 231 |
Veins invasion | 1 (0.4%) |
Arteries invasion | 0 |
Gut invasion | 1 (0.4%) |
Tumor < 4 cm | 23 (10.0%) |
Lymphadenopathy | 12 (5.2%) |
Liver metastases | 0 |
Peritoneal metastases | 0 |
Ascites | 0 |
Dilated bile ducts | 21 (9.1%) |
Inhomogeneous pancreas | 10 (4.3%) |
Fluid sequestration | 0 |
Abscesses | 0 |
Pancreatic fluid collections | 0 |
Wirsung lithiasis | 1 (0.4%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Selective angiography
Figure 28: Distribution of patients with any of the listed Selective angiography.
Table 12: Distribution of patients with any of the listed Selective angiography.
Variable | Total |
N= | 231 |
Portal vein invasion | 2 (0.9%) |
Superior mesenteric vein invasion | 0 |
Confluent invasion | 0 |
Celiac trunk invasion | 0 |
Superior mesenteric artery invasion | 0 |
Common hepatic artery invasion | 0 |
Splenic artery invasion | 0 |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
MR angiography
Figure 29: Distribution of patients with any of the listed MR angiography.
Table 13: Distribution of patients with any of the listed MR angiography.
Variable | Total |
N= | 231 |
Portal vein invasion | 1 (0.4%) |
Superior mesenteric vein invasion | 1 (0.4%) |
Confluent invasion | 1 (0.4%) |
Celiac trunk invasion | 0 |
Superior mesenteric artery invasion | 0 |
Common hepatic artery invasion | 0 |
Splenic artery invasion | 0 |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
MR Cholangiopancreatography
Figure 30: Distribution of patients with any of the listed MR Cholangiopancreatography.
Table 14: Distribution of patients with any of the listed MR Cholangiopancreatography.
Variable | Total |
N= | 231 |
Principal bile ducts dilation | 23 (10.0%) |
Intrahepatic bile ducts dilation | 17 (7.4%) |
Principal bile ducts obstruction | 15 (6.5%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
ERCP
Figure 31: Distribution of patients with any of the listed ERCP.
Table 15: Distribution of patients with any of the listed ERCP.
Variable | Total |
N= | 231 |
Visible tumor | 52 (22.5%) |
Biopsy | 45 (19.5%) |
Intrahepatic bile ducts dilation | 46 (19.9%) |
Stent | 78 (33.8%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Echoendoscopy
Figure 32: Distribution of patients with any of the listed Echoendoscopy.
Table 16: Distribution of patients with any of the listed Echoendoscopy.
Variable | Total |
N= | 231 |
Veins invasion | 4 (1.7%) |
Arteries invasion | 3 (1.3%) |
Gut invasion | 63 (27.3%) |
Tumor < 4 cm | 6 (2.6%) |
Lymphadenopathy | 19 (8.2%) |
Biopsy | 34 (14.7%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Laparoscopy
Figure 33: Distribution of patients with any of the listed Laparoscopy.
Table 17: Distribution of patients with any of the listed Laparoscopy.
Variable | Total |
N= | 231 |
Biopsy | 0 |
Lavaj-citologie | 0 |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Adjacent organ invasion
Figure 34: Distribution of patients with any of the listed Adjacent organ invasion.
Table 18: Distribution of patients with any of the listed Adjacent organ invasion.
Variable | Total |
N= | 231 |
Stomach | 1 (0.4%) |
Duoden | 14 (6.1%) |
Transverse colon | 1 (0.4%) |
Transverse mesocolon | 2 (0.9%) |
Spleen | 0 |
Kidney | 0 |
Other | 2 (0.9%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Vascular invasion
Figure 35: Distribution of patients with any of the listed Vascular invasion.
Table 19: Distribution of patients with any of the listed Vascular invasion.
Variable | Total |
N= | 231 |
Portal vein | 18 (7.8%) |
Superior mesenteric vein | 10 (4.3%) |
Confluent | 3 (1.3%) |
Celiac trunk | 0 |
Superior mesenteric artery | 4 (1.7%) |
Common hepatic artery | 0 |
Splenic artery | 0 |
Other | 1 (0.4%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Associated operations
Figure 36: Distribution of patients with any of the listed Associated operations.
Table 20: Distribution of patients with any of the listed Associated operations.
Variable | Total |
N= | 231 |
Wedger venous resection | 15 (6.5%) |
Segmentar venous resection | 9 (3.9%) |
Liver resection | 1 (0.4%) |
Other | 11 (4.8%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Tratament bont pancreatic
Figure 37: Distribution of patients with any of the listed Tratament bont pancreatic.
Table 21: Distribution of patients with any of the listed Tratament bont pancreatic.
Variable | Total |
N= | 231 |
Wirsung occlusion | 0 |
Tratament bont pancreatic - Pancreaticogastrostomy | 143 (61.9%) |
Tratament bont pancreatic - Pancreaticojejunostomy | 23 (10.0%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Complications
Figure 38: Distribution of patients with any of the listed Complications.
Table 22: Distribution of patients with any of the listed Complications.
Variable | Total |
N= | 231 |
Pancreatic fistula | 16 (6.9%) |
Bile ducts fistula | 7 (3.0%) |
Digestive fistula | 3 (1.3%) |
Hemorrhage | 11 (4.8%) |
Gastric stasis | 24 (10.4%) |
Pancreatita bont | 3 (1.3%) |
Peritonits | 1 (0.4%) |
Suppuration | 22 (9.5%) |
Intraperitoneala hemorrhage | 2 (0.9%) |
Septic shock | 1 (0.4%) |
Pulmonar | 8 (3.5%) |
Cardiovascular | 10 (4.3%) |
Hepatic | 4 (1.7%) |
Other | 22 (9.5%) |
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); |
Simptoms
Signs
Comorbidities
Toxics
Ultrasound
Abdominal CT
MRI
Selective angiography
MR angiography
MR Cholangiopancreatography
ERCP
Echoendoscopy
Laparoscopy
Acute pancreatitis
Adjacent organ invasion
Vascular invasion
Associated operations
Tratament bont pancreatic
Complications