Open AccessRisk factors for development of nonalcoholic fatty liver disease after pancreatoduodenectomy
Author(s) -
Fujii Yoshiro,
Nanashima Atsushi,
Hiyoshi Masahide,
Imamura Naoya,
Yano Koichi,
Hamada Takeomi
Publication year - 2017
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12024
Subject(s) - medicine , nonalcoholic fatty liver disease , gastroenterology , pancreaticoduodenectomy , univariate analysis , fatty liver , multivariate analysis , risk factor , disease , surgery , pancreas
Considerable attention has been focused on nonalcoholic fatty liver disease ( NAFLD ) which occasionally develops after pancreatoduodenectomy ( PD ). The present study aimed to clarify the prevalence, sequential change in properties and risk factors for NAFLD development after PD . We enrolled 196 patients who underwent PD and a computed tomography ( CT ) scan 1 month, 6 months and 1 year after surgery. NAFLD was defined as a liver‐to‐spleen attenuation ratio on plain CT of <0.9. We compared various clinical factors between the NAFLD group and the control group. Individual prevalence of NAFLD at 1 month, 6 months and 1 year after surgery was 12%, 21% and 15%. Significantly different factors by univariate analysis were as follows: 1 month: age, sex, total protein ( TP ), total cholesterol ( TC ) and copper (Cu); 6 months: sex, disease, surgical method, portal vein resection ( PVR ), frequency of defecation, TC and Cu; 1 year: age, sex, disease, surgical method, PVR , frequency of defecation, TP and Cu. Risk factors by multivariate analysis were as follows: 1 month: not elderly age, female sex and a decrease in Cu; 6 months: female sex and a decrease in Cu; 1 year: a decrease in Cu. NAFLD after PD frequently developed in women with a decrease in serum Cu and was influenced by various factors related to poor digestion and absorption associated with pancreatic exocrine insufficiency.