Development of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) after pancreaticoduodenectomy: Proposal of a postoperative NAFLD scoring system

Hiroyuki Kato, Shuji Isaji, Yoshinori Azumi, Masashi Kishiwada, Takashi Hamada, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai, Masami Tabata

研究成果: Article査読

51 被引用数 (Scopus)

抄録

Background: The main etiology of NAFLD and NASH after pancreatic resection is still unclear, and the therapeutic strategy has yet to be established. The focus of this review is how predict and prevent NAFLD/NASH after pancreaticoduodenectomy. Methods: From April 2005 to October 2008, 54 patients who underwent pancreaticoduodenectomy in our institution were enrolled in this study. From the pre-, intra- and postoperative risk factors, we identified the most influential risk factors of postoperative NAFLD by uni- and multivariate analyses. Moreover, a postoperative NAFLD scoring system was proposed based on these risk factors. Results: The incidence of postoperative NAFLD was 37.0% (20/54). Of these, 10% (2/20) of patients were diagnosed as having NASH by percutaneous liver biopsy. By multivariate analysis, pancreatic adenocarcinoma (p<0.05), pancreatic resection line (p<0.01) and postoperative diarrhea (p<0.01) were identified as the most influential factors concerning postoperative NAFLD. Based on these results, we proposed a postoperative NAFLD scoring system (0-10) and evaluated the correlation between the score and decreasing rates of CT values, revealing a significant correlation (r = 0.829 p<0.001). The prevalence of postoperative NAFLD in the patients with our scores of 0-3, 4-6 and 7-10 points was 0 (0/22), 35 (6/17) and 93% (14/15), respectively. Conclusions: In conclusion, NAFLD develops frequently in patients who undergo PD, and some patients even progress to NASH. A postoperative NAFLD scoring system makes it possible to predict the occurrence of NAFLD after PD, and aggressive nutrition support is needed for patients with high scores.

本文言語English
ページ(範囲)296-304
ページ数9
ジャーナルJournal of Hepato-Biliary-Pancreatic Sciences
17
3
DOI
出版ステータスPublished - 05-2010
外部発表はい

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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