title: The impact of body mass index on pancreatic fistula after pancreaticoduodenectomy in Asian patients on the basis of Asia-Pacific perspective of body mass index.
abstract: BACKGROUND
  Several surgical complications are related to obesity.
  
  
  OBJECTIVE
  This study evaluated the impact of obesity on pancreatic fistula after pancreaticoduodenectomy.
  
  
  METHODS
  We retrospectively reviewed the medical records of 159 patients who underwent pancreaticoduodenectomy between October 2002 and December 2008.
  
  
  METHODS
  The patients were divided according to the body mass index as obese (body mass index equal to, or greater than, 25 kg/m(2)), or normal (body mass index less than 25 kg/m(2)).
  
  
  METHODS
  Univariate and multivariate analyses were applied. Two-tailed P values less than 0.05 were considered as significant.
  
  
  RESULTS
  Forty-six patients (28.9%) were obese and 113 patients (71.1%) were normal-weight. Obese group had a significantly higher incidence of pancreatic fistula and a greater amount of intraoperative blood loss. Other surgical complications were not significantly different between the two groups. Multivariate analysis found obesity, small pancreatic duct size (less than, or equal to, 3 mm), intraoperative blood loss, and combined resection as significant factors affecting pancreatic fistula.
  
  
  CONCLUSIONS
  Obese patients have an increased risk for pancreatic fistula after pancreaticoduodenectomy.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Ho Kyoung
authors.initials: HK
authors.lastname: Hwang
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Park
authors.forename: Chan Il
authors.initials: CI
authors.lastname: Park
authors.forename: Jae Keun
authors.initials: JK
authors.lastname: Kim
authors.forename: Dong Sup
authors.initials: DS
authors.lastname: Yoon
mesh_terms: D000368:Aged; D001208:Asia / Q000453:epidemiology; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D010140:Pacific Ocean; D010185:Pancreatic Fistula / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies