Significant positive impact of duodenum-preserving pancreatic head resection on the prevention of postoperative nonalcoholic fatty liver disease and acute cholangitis

Hiroyuki Kato, Yukio Asano, Masahiro Ito, Satoshi Arakawa, Masahiro Shimura, Daisuke Koike, Chihiro Hayashi, Kenshiro Kamio, Toki Kawai, Akihiko Horiguchi

研究成果: ジャーナルへの寄稿学術論文査読

3 被引用数 (Scopus)

抄録

Aim: This study aimed to compare the incidence of postoperative nonalcoholic fatty liver disease (NAFLD), postoperative cholangitis, and fibrosis-4 (FIB)-4 index in patients who underwent duodenum-preserving pancreatic head resection (DPPHR) and pancreaticoduodenectomy (PD) for low-grade malignant tumors and verify the usefulness of DPPHR in preventing the occurrence of these disorders. Methods: This retrospective study included 70 patients who underwent PD (n = 39) and DPPHR (n = 31) between 2006 and 2018 for benign or low-grade malignant tumors. The present study compared the preoperative background, cumulative incidence of postoperative NAFLD and cholangitis, and other biochemical markers, including the FIB-4 index. Subanalysis by propensity score matching (PSM) analysis was conducted to minimize treatment selection bias. Results: In terms of the cumulative incidence of NAFLD, the 5-y incidence was significantly lower in the DPPHR group than in the PD group both before (10% vs 38%, P =.002) and after (13% vs 38%, P =.008) matching. Multivariate analyses identified DPPHR as the only independent preventive factor for postoperative NAFLD (hazard ratio: 0.160, 95% confidence intervals: 0.034–0.76, P =.021). The 5-y cumulative incidence of postoperative cholangitis was significantly higher in the PD group than in the DPPHR group before (51% vs 3%, P <.001) and after (49% vs 4%, P <.001) matching. The FIB-4 index at 12 mo postoperatively was significantly better in the DPPHR group than in the PD group (1.45 vs 2.35, P =.006) before matching. Conclusion: Preservation of the duodenum and bile duct may contribute to preventing long-term postoperative NAFLD and cholangitis, and liver fibrosis for benign or low-grade malignant pancreatic head tumors.

本文言語英語
ページ(範囲)851-861
ページ数11
ジャーナルAnnals of Gastroenterological Surgery
6
6
DOI
出版ステータス出版済み - 11-2022

All Science Journal Classification (ASJC) codes

  • 外科
  • 消化器病学

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