BACKGROUND: The purpose of this study was to examine the preoperative patient and radiographic factors that are associated with operative morbidity after pancreaticoduodenectomy. MATERIAL AND METHODS: Patient characteristics and preoperative radiographic findings and their association with postoperative complications after pancreaticoduodenectomy were analyzed for 356 patients with pancreatic adenocarcinoma who underwent resection between 2000 and 2005. RESULTS: Postoperative complications developed in 135 patients (38%). The most common complications were pancreatic fistula/abscess (15%), wound infection (14%), and delayed gastric emptying (4%). On multivariate analysis, the only preoperative radiographic factors associated with having any postoperative complication were the absence of pancreatic atrophy and the extent of central obesity determined by the thickness of retrorenal visceral fat (VF). Complications occurred in 51% of patients with VF > or = 2 cm, compared to 31% of patients with VF < 2 cm, p < 0.001. Postoperatively, pancreatic fistula developed in 24% of patients with VF > or = 2 cm and in only 10% of patients with VF < 2 cm, p = 0.01. Wound infections occurred in 21% of the patients with body mass index greater than or equal to 30 kg/m(2) compared to 12% of the nonobese patients, p = 0.03. CONCLUSIONS: Generalized obesity is associated with postoperative wound infections after pancreaticoduodenectomy. The degree of visceral fat on preoperative cross-sectional imaging is associated with significantly higher rates of overall complications and pancreatic fistula.
BACKGROUND: The purpose of this study was to examine the preoperative patient and radiographic factors that are associated with operative morbidity after pancreaticoduodenectomy. MATERIAL AND METHODS:Patient characteristics and preoperative radiographic findings and their association with postoperative complications after pancreaticoduodenectomy were analyzed for 356 patients with pancreatic adenocarcinoma who underwent resection between 2000 and 2005. RESULTS:Postoperative complications developed in 135 patients (38%). The most common complications were pancreatic fistula/abscess (15%), wound infection (14%), and delayed gastric emptying (4%). On multivariate analysis, the only preoperative radiographic factors associated with having any postoperative complication were the absence of pancreatic atrophy and the extent of central obesity determined by the thickness of retrorenal visceral fat (VF). Complications occurred in 51% of patients with VF > or = 2 cm, compared to 31% of patients with VF < 2 cm, p < 0.001. Postoperatively, pancreatic fistula developed in 24% of patients with VF > or = 2 cm and in only 10% of patients with VF < 2 cm, p = 0.01. Wound infections occurred in 21% of the patients with body mass index greater than or equal to 30 kg/m(2) compared to 12% of the nonobese patients, p = 0.03. CONCLUSIONS: Generalized obesity is associated with postoperative wound infections after pancreaticoduodenectomy. The degree of visceral fat on preoperative cross-sectional imaging is associated with significantly higher rates of overall complications and pancreatic fistula.
Authors: Jordan M Winter; John L Cameron; Kurtis A Campbell; David C Chang; Taylor S Riall; Richard D Schulick; Michael A Choti; JoAnn Coleman; Mary B Hodgin; Patricia K Sauter; Christopher J Sonnenday; Christopher L Wolfgang; Michael R Marohn; Charles J Yeo Journal: J Gastrointest Surg Date: 2006-11 Impact factor: 3.452
Authors: Michelle L DeOliveira; Jordan M Winter; Markus Schafer; Steven C Cunningham; John L Cameron; Charles J Yeo; Pierre-Alain Clavien Journal: Ann Surg Date: 2006-12 Impact factor: 12.969
Authors: Jordan M Winter; John L Cameron; Charles J Yeo; Babatunde Alao; Keith D Lillemoe; Kurtis A Campbell; Richard D Schulick Journal: J Am Coll Surg Date: 2007-03-27 Impact factor: 6.113
Authors: Amit K Mathur; Amir A Ghaferi; Nicholas H Osborne; Timothy M Pawlik; Darrell A Campbell; Michael J Englesbe; Theodore H Welling Journal: J Gastrointest Surg Date: 2010-06-08 Impact factor: 3.452
Authors: Robert M Cannon; Ryan LeGrand; Ryaz B Chagpar; Syed A Ahmad; Rebecca McClaine; Hong Jin Kim; Christopher Rupp; Cliff S Cho; Adam Brinkman; Sharon Weber; Emily R Winslow; David A Kooby; Carrie K Chu; Charles A Staley; Ian Glenn; William G Hawkins; Alexander A Parikh; Nipun B Merchant; Kelly M McMasters; Robert C G Martin; Glenda G Callender; Charles R Scoggins Journal: HPB (Oxford) Date: 2012-01-19 Impact factor: 3.647
Authors: Kathryn M Ziegler; Robert V Considine; Eben True; Deborah A Swartz-Basile; Henry A Pitt; Nicholas J Zyromski Journal: Int J Surg Date: 2016-03-05 Impact factor: 6.071
Authors: Sowmya Narayanan; Allison N Martin; Florence E Turrentine; Todd W Bauer; Reid B Adams; Victor M Zaydfudim Journal: J Surg Res Date: 2018-06-27 Impact factor: 2.192
Authors: John C McAuliffe; Karen Parks; Prakash Kumar; Sandre F McNeal; Desiree E Morgan; John D Christein Journal: HPB (Oxford) Date: 2013-01-10 Impact factor: 3.647
Authors: Raphael C Sun; Anna M Button; Brian J Smith; Richard F Leblond; James R Howe; James J Mezhir Journal: J Gastrointest Surg Date: 2013-02-20 Impact factor: 3.452
Authors: A Floortje van Oosten; Ding Ding; Joseph R Habib; Ahmer Irfan; Ryan K Schmocker; Elisabetta Sereni; Benedict Kinny-Köster; Michael Wright; Vincent P Groot; I Quintus Molenaar; John L Cameron; Martin Makary; Richard A Burkhart; William R Burns; Christopher L Wolfgang; Jin He Journal: J Gastrointest Surg Date: 2020-11-17 Impact factor: 3.452