The impact of pylorus preservation on the development of nonalcoholic fatty liver disease after pancreaticoduodenectomy: A historical cohort study

Background/Purpose The pathophysiology and associated factors of nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD) remain elusive. We aimed to investigate these factors, including the operation type, for NAFLD development after PD. Methods This historical cohort study inclu...

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Published in:Journal of hepato-biliary-pancreatic sciences 2022-08, Vol.29 (8), p.863-873
Main Authors: Jeon, Dongsub, Park, Bum Ho, Lee, Han Chu, Park, Yejong, Lee, Woohyung, Lee, Jae Hoon, Song, Ki Byung, Hwang, Dae Wook, Kim, Song Cheol, Choi, Jonggi
Format: Article
Language:English
Subjects:
Body mass index
Cohort analysis
fatty liver
Liver diseases
malnutrition
nonalcoholic fatty liver disease
Pancreaticoduodenectomy
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Summary:Background/Purpose The pathophysiology and associated factors of nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD) remain elusive. We aimed to investigate these factors, including the operation type, for NAFLD development after PD. Methods This historical cohort study included 786 consecutive patients treated with either classic Whipple operation or pylorus‐preserving pancreaticoduodenectomy (PPPD) in Korea between 2012 and 2018. De novo NAFLD was determined based on hepatic attenuation in nonenhanced computed tomography during follow‐up. Results Of the 786 patients, 216 (27.5%) had a newly developed NAFLD at 2 years after PD. The incidences of newly developed NAFLD at 0.5, 1, 1.5, and 2 years were 13 (1.7%), 41 (5.2%), 48 (6.1%), and 114 (14.5%), respectively. The Whipple group showed a significantly higher incidence of NAFLD than the PPPD group (40.3% vs 24.5%, P 
ISSN:1868-6974
1868-6982
DOI:10.1002/jhbp.1150