Clinical Characteristics and Risk Factors for the Development of Postoperative Hepatic Steatosis After Total Pancreatectomy.
OBJECTIVE
The occurrence of hepatic steatosis after pancreatectomy is known to be associated with the remnant pancreatic function. However, other risk factors for hepatic steatosis after pancreatectomy remain unknown. The aims of this study were to identify other risk factors in addition to the remnant pancreatic function and elucidate the relationship between postoperative hepatic steatosis and pancreatic exocrine insufficiency in totally pancreatomized patients.


METHODS
Forty-three patients who underwent total pancreatectomy were analyzed. Hepatic steatosis was defined as the attenuation of unenhanced computed tomography values. Clinical findings and laboratory data were compared between patients with and without hepatic steatosis.


RESULTS
Sixteen (37.2%) patients developed hepatic steatosis after total pancreatectomy, with marked declines in the Controlling Nutritional Status score and body mass index. Multiple linear regression analysis revealed that the attenuation of computed tomography values was correlated with female sex (P = 0.002), early postoperative serum albumin levels (P = 0.003), and pancreatic enzyme replacement therapy with high-dose pancrelipase (P = 0.032).


CONCLUSIONS
Postoperative hepatic steatosis after pancreatectomy is associated with sex, malnutrition, and pancreatic exocrine insufficiency. High-dose pancreatic enzyme replacement therapy may have preventive effects on hepatic steatosis occurring after pancreatectomy.
From the *Department of Surgery and †Division of Integrated Surgery and Oncology, Department of Surgery, Tohoku University Graduate School of Medicine; and ‡Division of International Cooperation for Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.
Tatsuo
T
Hata
Masaharu
M
Ishida
Fuyuhiko
F
Motoi
Naoaki
N
Sakata
Gumpei
G
Yoshimatsu
Takeshi
T
Naitoh
Yu
Y
Katayose
Shinichi
S
Egawa
Michiaki
M
Unno
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D010188:Exocrine Pancreatic Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology*; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D012737:Sex Factors; D014057:Tomography, X-Ray Computed
D012709:Serum Albumin