AIM: To identify risk factors for nonalcoholic steatohepatitis following pancreaticoduodenectomy, with a focus on factors related to pancreatic secretions. METHODS: The medical records of 228 patients who had a pancreaticoduodenectomy over a 16-mo period were reviewed retrospectively. The 193 patients who did not have fatty liver disease preoperatively were included in the final analysis. Hepatic steatosis was diagnosed using the differences between splenic and hepatic attenuation and liver-to-spleen attenuation as measured by non-enhanced computed tomography. RESULTS: Fifteen patients (7.8%) who showed postoperative hepatic fatty changes were assigned to Group A, and the remaining patients were assigned to Group B. Patient demographics, preoperative laboratory findings (including levels of C-peptide, glucagon, insulin and glucose tolerance test results), operation types, and final pathological findings did not differ significantly between the two groups; however, the frequency of pancreatic fistula (P = 0.020) and the method of pancreatic duct stenting (P = 0.005) showed significant differences between the groups. A multivariate analysis identified pancreatic fistula (HR = 3.332, P = 0.037) and external pancreatic duct stenting (HR = 4.530, P = 0.017) as independent risk factors for the development of postoperative steatohepatitis. CONCLUSION: Pancreatic fistula and external pancreatic duct stenting were identified as independent risk factors for the development of steatohepatitis following pancreaticoduodenectomy.
AIM: To identify risk factors for nonalcoholic steatohepatitis following pancreaticoduodenectomy, with a focus on factors related to pancreatic secretions. METHODS: The medical records of 228 patients who had a pancreaticoduodenectomy over a 16-mo period were reviewed retrospectively. The 193 patients who did not have fatty liver disease preoperatively were included in the final analysis. Hepatic steatosis was diagnosed using the differences between splenic and hepatic attenuation and liver-to-spleen attenuation as measured by non-enhanced computed tomography. RESULTS: Fifteen patients (7.8%) who showed postoperative hepatic fatty changes were assigned to Group A, and the remaining patients were assigned to Group B. Patient demographics, preoperative laboratory findings (including levels of C-peptide, glucagon, insulin and glucose tolerance test results), operation types, and final pathological findings did not differ significantly between the two groups; however, the frequency of pancreatic fistula (P = 0.020) and the method of pancreatic duct stenting (P = 0.005) showed significant differences between the groups. A multivariate analysis identified pancreatic fistula (HR = 3.332, P = 0.037) and external pancreatic duct stenting (HR = 4.530, P = 0.017) as independent risk factors for the development of postoperative steatohepatitis. CONCLUSION:Pancreatic fistula and external pancreatic duct stenting were identified as independent risk factors for the development of steatohepatitis following pancreaticoduodenectomy.
Authors: Erwin-Jan M van Geenen; Mark M Smits; Tim C M A Schreuder; Donald L van der Peet; Elisabeth Bloemena; Chris J J Mulder Journal: Pancreas Date: 2010-11 Impact factor: 3.327
Authors: Amit D Tevar; Calissia Clarke; Jiang Wang; Steven M Rudich; E Steve Woodle; Alex B Lentsch; Michael L Edwards Journal: J Am Coll Surg Date: 2010-04 Impact factor: 6.113
Authors: Gwendolyn M P Diepenhorst; Oddeke van Ruler; Marc G H Besselink; Hjalmar C van Santvoort; Paul R Wijnandts; Willem Renooij; Dirk J Gouma; Hein G Gooszen; Marja A Boermeester Journal: Shock Date: 2011-01 Impact factor: 3.454
Authors: J J Huang; C J Yeo; T A Sohn; K D Lillemoe; P K Sauter; J Coleman; R H Hruban; J L Cameron Journal: Ann Surg Date: 2000-06 Impact factor: 12.969
Authors: Francisco José Morera-Ocon; Luis Sabater-Orti; Elena Muñoz-Forner; Jaime Pérez-Griera; Joaquín Ortega-Serrano Journal: World J Gastrointest Oncol Date: 2014-09-15
Authors: Tara Michella Mackay; Cansu Güney Genç; Robert Bart Takkenberg; Marc Gerard Besselink; Inne Somers; Elisabeth Jacqueline Maria Nieveen van Dijkum Journal: J Surg Oncol Date: 2018-03-24 Impact factor: 3.454