title: Extensive lymph node dissection during pancreaticoduodenectomy: a risk factor for hepatic steatosis?
abstract: The first reports of hepatic steatosis following pancreaticoduodenectomy (PD) were published several years ago; however, clear risk factors remain to be identified. Therefore, the aim of this study was to identify the risk factors for hepatic steatosis post-PD.
  
  
  
  We studied 90 patients who had undergone PD between September 2005 and January 2015. The inclusion criteria were as follows: available unenhanced CT within one month before PD and at least one unenhanced CT acquisition between PD and chemotherapy initiation. Using scanners, we studied the liver and spleen density as well as the surface areas of visceral (VF) and subcutaneous fat (SCF). These variables were previously identified by univariate and multivariate analyses.
  
  
  
  Hepatic steatosis occurred in 25.6% of patients at 45.2 days, on average, post-PD. Among the patients with hepatic steatosis, the average liver density was 52 HU before PD and 15.1 HU post-PD (p < 0.001). The Patients with hepatic steatosis lost more VF (mean, 28 vs. 11 cm2) and SCF (28.8 vs. 13.7 cm2) (p < 0.01 and p = 0.01, respectively). Portal vein resection and extensive lymph node dissection were independent risk factors in the multivariate analysis (odds ratio [OR] 5.29, p = 0.009; OR 3.38, p = 0.04, respectively).
  
  
  
  Portal vein resection and extensive lymph node dissection are independent risk factors for post-PD hepatic steatosis.
authors.affiliation: Department of Radiology, CHU Nancy Brabois, Vandœuvre-lès-Nancy, 54500, France. mignot.aureline3@hotmail.fr.|, 6 rue Jean XXIII Résidence Haut Rivage, 54130, Saint Max, France. mignot.aureline3@hotmail.fr.
authors.forename: A
authors.initials: A
authors.lastname: Mignot
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, CHU Nancy Brabois, Vandœuvre-lès-Nancy, 54500, France.
authors.forename: A
authors.initials: A
authors.lastname: Ayav
authors.affiliation: Department of Diabetes and Nutrition, CHU Nancy Brabois, Vandœuvre-lès-Nancy, 54500, France.
authors.forename: D
authors.initials: D
authors.lastname: Quillot
authors.affiliation: Department of Cardiovascular Medicine, CHU Nancy Brabois, Vandœuvre-lès-Nancy, 54500, France.
authors.forename: S
authors.initials: S
authors.lastname: Zuily
authors.affiliation: Department of Radiology, CHU Nancy Brabois, Vandœuvre-lès-Nancy, 54500, France.
authors.forename: I
authors.initials: I
authors.lastname: Petit
authors.affiliation: Department of PARC, ESPRI-BIOBASE, Pôle S, CHU Nancy Brabois, Vandœuvre-lès-Nancy, 54500, France.
authors.forename: P L
authors.initials: PL
authors.lastname: Nguyen-Thi
authors.affiliation: Department of Diabetes and Nutrition, CHU Nancy Brabois, Vandœuvre-lès-Nancy, 54500, France.
authors.forename: A
authors.initials: A
authors.lastname: Malgras
authors.affiliation: Department of Radiology, CHU Nancy Brabois, Vandœuvre-lès-Nancy, 54500, France.
authors.forename: V
authors.initials: V
authors.lastname: Laurent
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
keywords: Cephalic pancreaticoduodenectomy; Extensive lymph node dissection; Hepatic steatosis; Portal vein resection