Paradoxical impact of the remnant pancreatic volume and infectious complications on the development of nonalcoholic fatty liver disease after pancreaticoduodenectomy

Rie Sato, Masashi Kishiwada, Naohisa Kuriyama, Yoshinori Azumi, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai, Masami Tabata, Tomomi Yamada, Shuji Isaji

研究成果: ジャーナルへの寄稿学術論文査読

45 被引用数 (Scopus)

抄録

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.

本文言語英語
ページ(範囲)562-572
ページ数11
ジャーナルJournal of Hepato-Biliary-Pancreatic Sciences
21
8
DOI
出版ステータス出版済み - 08-2014
外部発表はい

All Science Journal Classification (ASJC) codes

  • 外科
  • 肝臓学

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