The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy
Abstract Background To study exocrine function of the remnant pancreas after pancreatoduodenectomy (PD), we propose the use of an exocrine index (PEI) that combines the volume of the remnant pancreas and the intraoperative amylase activity of the pancreatic juice. Here, we aimed to determine whether...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-09-01
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| Series: | Annals of Gastroenterological Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ags3.12572 |
| _version_ | 1818066161199218688 |
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| author | Masashi Tsunematsu Takeshi Gocho Mitsuru Yanagaki Yoshihiro Shirai Koichiro Haruki Kenei Furukawa Jungo Yasuda Shinji Onda Taro Sakamoto Toru Ikegami |
| author_facet | Masashi Tsunematsu Takeshi Gocho Mitsuru Yanagaki Yoshihiro Shirai Koichiro Haruki Kenei Furukawa Jungo Yasuda Shinji Onda Taro Sakamoto Toru Ikegami |
| author_sort | Masashi Tsunematsu |
| collection | DOAJ |
| description | Abstract Background To study exocrine function of the remnant pancreas after pancreatoduodenectomy (PD), we propose the use of an exocrine index (PEI) that combines the volume of the remnant pancreas and the intraoperative amylase activity of the pancreatic juice. Here, we aimed to determine whether the PEI can predict non‐alcoholic fatty liver disease (NAFLD) following PD. Methods Fifty‐seven patients for whom pancreatic juice amylase activity was measured during PD were enrolled. NAFLD was defined as a liver‐to‐spleen attenuation ratio of <0.9 on plain CT 1 year following surgery. We retrospectively evaluated clinical parameters, including the PEI, to identify predictors of NAFLD. Results Fifty‐four patients (95%) were regularly administered 1200 mg of pancreatic lipase. NAFLD was diagnosed in 13 participants (23%) 1 year following surgery. NAFLD was associated with pancreatic ductal adenocarcinoma (P = .006), soft pancreas (P = .001), small main pancreatic duct (P = 0008), low remnant pancreatic volume (P < .001), low intraoperative amylase activity in the pancreatic juice (P = .001), high pancreatic fibrosis (P = .032), and large body weight loss (P = .015). The PEI was significantly lower in the participants with NAFLD than in those without (P < .001). The participants were then classified into tertiles of PEI: <5 × 106, 5‐25 × 106, and >25 × 106. The prevalence of NAFLD in these groups was 53% (10/19), 11% (2/19), and 5% (1/19), respectively. In multivariable analyses, there was a significant association between NAFLD and the PEI (P value for trend = .042). Conclusion The PEI, calculated using the remnant pancreatic volume and the intraoperative pancreatic juice amylase activity, predicts NAFLD development following PD. |
| first_indexed | 2024-12-10T15:03:23Z |
| format | Article |
| id | doaj.art-98c856ca50e64e73912022d195d42129 |
| institution | Directory Open Access Journal |
| issn | 2475-0328 |
| language | English |
| last_indexed | 2024-12-10T15:03:23Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj.art-98c856ca50e64e73912022d195d421292022-12-22T01:44:07ZengWileyAnnals of Gastroenterological Surgery2475-03282022-09-016570471110.1002/ags3.12572The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomyMasashi Tsunematsu0Takeshi Gocho1Mitsuru Yanagaki2Yoshihiro Shirai3Koichiro Haruki4Kenei Furukawa5Jungo Yasuda6Shinji Onda7Taro Sakamoto8Toru Ikegami9Department of Surgery The Jikei University School of Medicine Tokyo JapanDepartment of Surgery The Jikei University School of Medicine Tokyo JapanDepartment of Surgery The Jikei University School of Medicine Tokyo JapanDepartment of Surgery The Jikei University School of Medicine Tokyo JapanDepartment of Surgery The Jikei University School of Medicine Tokyo JapanDepartment of Surgery The Jikei University School of Medicine Tokyo JapanDepartment of Surgery The Jikei University School of Medicine Tokyo JapanDepartment of Surgery The Jikei University School of Medicine Tokyo JapanDepartment of Surgery The Jikei University School of Medicine Tokyo JapanDepartment of Surgery The Jikei University School of Medicine Tokyo JapanAbstract Background To study exocrine function of the remnant pancreas after pancreatoduodenectomy (PD), we propose the use of an exocrine index (PEI) that combines the volume of the remnant pancreas and the intraoperative amylase activity of the pancreatic juice. Here, we aimed to determine whether the PEI can predict non‐alcoholic fatty liver disease (NAFLD) following PD. Methods Fifty‐seven patients for whom pancreatic juice amylase activity was measured during PD were enrolled. NAFLD was defined as a liver‐to‐spleen attenuation ratio of <0.9 on plain CT 1 year following surgery. We retrospectively evaluated clinical parameters, including the PEI, to identify predictors of NAFLD. Results Fifty‐four patients (95%) were regularly administered 1200 mg of pancreatic lipase. NAFLD was diagnosed in 13 participants (23%) 1 year following surgery. NAFLD was associated with pancreatic ductal adenocarcinoma (P = .006), soft pancreas (P = .001), small main pancreatic duct (P = 0008), low remnant pancreatic volume (P < .001), low intraoperative amylase activity in the pancreatic juice (P = .001), high pancreatic fibrosis (P = .032), and large body weight loss (P = .015). The PEI was significantly lower in the participants with NAFLD than in those without (P < .001). The participants were then classified into tertiles of PEI: <5 × 106, 5‐25 × 106, and >25 × 106. The prevalence of NAFLD in these groups was 53% (10/19), 11% (2/19), and 5% (1/19), respectively. In multivariable analyses, there was a significant association between NAFLD and the PEI (P value for trend = .042). Conclusion The PEI, calculated using the remnant pancreatic volume and the intraoperative pancreatic juice amylase activity, predicts NAFLD development following PD.https://doi.org/10.1002/ags3.12572diabetes mellitusexocrine indexnon‐alcoholic fatty liver diseasepancreatic juicepancreaticoduodenectomy |
| spellingShingle | Masashi Tsunematsu Takeshi Gocho Mitsuru Yanagaki Yoshihiro Shirai Koichiro Haruki Kenei Furukawa Jungo Yasuda Shinji Onda Taro Sakamoto Toru Ikegami The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy Annals of Gastroenterological Surgery diabetes mellitus exocrine index non‐alcoholic fatty liver disease pancreatic juice pancreaticoduodenectomy |
| title | The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy |
| title_full | The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy |
| title_fullStr | The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy |
| title_full_unstemmed | The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy |
| title_short | The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy |
| title_sort | impact of postoperative exocrine index on non alcoholic fatty liver disease following pancreaticoduodenectomy |
| topic | diabetes mellitus exocrine index non‐alcoholic fatty liver disease pancreatic juice pancreaticoduodenectomy |
| url | https://doi.org/10.1002/ags3.12572 |
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