Incidence and risk factors of nonalcoholic fatty liver disease after total pancreatectomy: A first multicenter prospective study in Japan
Corresponding Author
Hiroyuki Kato
Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan
Correspondence
Hiroyuki Kato, Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan.
Email: [email protected]
Search for more papers by this authorKeiko Kamei
Department of Surgery, Kindai University, Osaka, Japan
Search for more papers by this authorHironobu Suto
Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan
Search for more papers by this authorTakeyuki Misawa
Department of Surgery, Jikei University Kashiwa Hospital, Chiba, Japan
Search for more papers by this authorMichiaki Unno
Department of Surgery, Tohoku University, Miyagi, Japan
Search for more papers by this authorHiroyuki Nitta
Department of Surgery, Iwate Medical University, Iwate, Japan
Search for more papers by this authorSohei Satoi
Department of Surgery, Kansai Medical University, Osaka, Japan
Search for more papers by this authorYasunari Kawabata
Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Shimane, Japan
Search for more papers by this authorMasayuki Ohtsuka
Department of General Surgery, Chiba University, Chiba, Japan
Search for more papers by this authorToshiki Rikiyama
Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorTakeshi Sudo
Department of Surgery, Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
Search for more papers by this authorIppei Matsumoto
Department of Surgery, Kindai University, Osaka, Japan
Search for more papers by this authorKeiichi Okano
Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan
Search for more papers by this authorYasuyuki Suzuki
Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan
Search for more papers by this authorNaohiro Sata
Department of Surgery, Jichi Medical University, Tochigi, Japan
Search for more papers by this authorYoshifumi Takeyama
Department of Surgery, Kindai University, Osaka, Japan
Search for more papers by this authorCorresponding Author
Hiroyuki Kato
Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan
Correspondence
Hiroyuki Kato, Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan.
Email: [email protected]
Search for more papers by this authorKeiko Kamei
Department of Surgery, Kindai University, Osaka, Japan
Search for more papers by this authorHironobu Suto
Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan
Search for more papers by this authorTakeyuki Misawa
Department of Surgery, Jikei University Kashiwa Hospital, Chiba, Japan
Search for more papers by this authorMichiaki Unno
Department of Surgery, Tohoku University, Miyagi, Japan
Search for more papers by this authorHiroyuki Nitta
Department of Surgery, Iwate Medical University, Iwate, Japan
Search for more papers by this authorSohei Satoi
Department of Surgery, Kansai Medical University, Osaka, Japan
Search for more papers by this authorYasunari Kawabata
Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Shimane, Japan
Search for more papers by this authorMasayuki Ohtsuka
Department of General Surgery, Chiba University, Chiba, Japan
Search for more papers by this authorToshiki Rikiyama
Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorTakeshi Sudo
Department of Surgery, Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
Search for more papers by this authorIppei Matsumoto
Department of Surgery, Kindai University, Osaka, Japan
Search for more papers by this authorKeiichi Okano
Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan
Search for more papers by this authorYasuyuki Suzuki
Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan
Search for more papers by this authorNaohiro Sata
Department of Surgery, Jichi Medical University, Tochigi, Japan
Search for more papers by this authorYoshifumi Takeyama
Department of Surgery, Kindai University, Osaka, Japan
Search for more papers by this authorRegistry and the Registration No. of the study/Trial: This trial was registered with UMIN-CTR (number UMIN000018763).
Abstract
Background/Purpose
In the present study we aimed to prospectively assess the current prevalence and risk factors of nonalcoholic fatty liver disease (NAFLD) after total pancreatectomy (TP).
Methods
Between August 2015 and December 2017, we prospectively collected data from 68 Japanese centers on 148 consecutive patients who underwent TP whose computed tomography (CT) attenuation values were evaluated for 12 months. We defined post-TP NAFLD as a liver parenchyma CT value of less than 40 Hounsfield units (HU). Data on perioperative variables were retrieved from all patients and evaluated using univariate and multivariate analyses to identify the perioperative risk factors of NAFLD.
Results
In this prospective cohort study, supplementation of pancreatic exocrine enzymes was provided to all 148 patients, and 97% of them were treated with high-titer pancrelipase (median dosage: 1800 mg) postoperatively. Indeed, 29 patients (19.6%) developed NAFLD within a year after TP. Multivariate analysis revealed that female sex (P = .002), higher body mass index (BMI) (P = .001), and postoperative diarrhea (P = .038) were independent risk factors for post-TP NAFLD. However, post-TP NAFLD ameliorated in 11 patients (37.9%) at 12 months after surgery.
Conclusions
Among patients with risk factors such as female sex, higher BMI, and postoperative diarrhea, attention should be paid to the occurrence of NAFLD after TP.
CONFLICT OF INTEREST
YT received lecture fee from Mylan EPD. Other authors have no potential conflicts of interest to disclose.
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