TY - JOUR
T1 - Paradoxical impact of the remnant pancreatic volume and infectious complications on the development of nonalcoholic fatty liver disease after pancreaticoduodenectomy
AU - Sato, Rie
AU - Kishiwada, Masashi
AU - Kuriyama, Naohisa
AU - Azumi, Yoshinori
AU - Mizuno, Shugo
AU - Usui, Masanobu
AU - Sakurai, Hiroyuki
AU - Tabata, Masami
AU - Yamada, Tomomi
AU - Isaji, Shuji
PY - 2014/8
Y1 - 2014/8
N2 - Background The aim of the present study was to evaluate perioperative risk factors for development of nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD), paying special attention to remnant pancreatic volume (RPV) and postoperative infection. Methods We reviewed the charts of 110 patients who had been followed more than 6 months after PD. These patients were classified into the two groups according to RPV measured by CT volumetry at one month: large-volume group (LVG) (10 ml or more, n = 75) and small-volume group (SVG) (less than 10 ml, n = 35). Results Nonalcoholic fatty liver disease developed in 44 (40.0%), being significantly higher in SVG than in LVG: 54.2% vs. 33.3% (P = 0.037). SVG was characterized as significantly higher incidence of pancreatic adenocarcinoma, while LVG was characterized as significantly higher incidences of soft pancreas, postoperative infection and pancreatic fistula. In LVG, the incidence of NAFLD was significantly higher in patients with suspicion of infection than in those without it: 45.2% vs. 18.1% (P = 0.014), while not different in SVG. By multivariate analysis, independent risk factor was determined as RPV and suspicion of infection in the whole patients, and in LVG it was suspicion of infection, while in SVG it was not identified. Conclusion After PD, RPV and status of postoperative infection paradoxically influenced the development of NAFLD.
AB - Background The aim of the present study was to evaluate perioperative risk factors for development of nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD), paying special attention to remnant pancreatic volume (RPV) and postoperative infection. Methods We reviewed the charts of 110 patients who had been followed more than 6 months after PD. These patients were classified into the two groups according to RPV measured by CT volumetry at one month: large-volume group (LVG) (10 ml or more, n = 75) and small-volume group (SVG) (less than 10 ml, n = 35). Results Nonalcoholic fatty liver disease developed in 44 (40.0%), being significantly higher in SVG than in LVG: 54.2% vs. 33.3% (P = 0.037). SVG was characterized as significantly higher incidence of pancreatic adenocarcinoma, while LVG was characterized as significantly higher incidences of soft pancreas, postoperative infection and pancreatic fistula. In LVG, the incidence of NAFLD was significantly higher in patients with suspicion of infection than in those without it: 45.2% vs. 18.1% (P = 0.014), while not different in SVG. By multivariate analysis, independent risk factor was determined as RPV and suspicion of infection in the whole patients, and in LVG it was suspicion of infection, while in SVG it was not identified. Conclusion After PD, RPV and status of postoperative infection paradoxically influenced the development of NAFLD.
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U2 - 10.1002/jhbp.115
DO - 10.1002/jhbp.115
M3 - Article
C2 - 24824077
AN - SCOPUS:84904608680
SN - 1868-6974
VL - 21
SP - 562
EP - 572
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
IS - 8
ER -