Clinical Characteristics and Risk Factors for the Development of Postoperative Hepatic Steatosis After Total Pancreatectomy

被引:29
作者
Hata, Tatsuo [1 ]
Ishida, Masaharu [1 ]
Motoi, Fuyuhiko [1 ]
Sakata, Naoaki [1 ]
Yoshimatsu, Gumpei [1 ]
Naitoh, Takeshi [1 ]
Katayose, Yu [1 ,2 ]
Egawa, Shinichi [3 ]
Unno, Michiaki [1 ,2 ]
机构
[1] Tohoku Univ, Grad Sch Med, Dept Surg, Sendai, Miyagi 980, Japan
[2] Tohoku Univ, Grad Sch Med, Dept Surg, Div Integrated Surg & Oncol, Sendai, Miyagi 980, Japan
[3] Tohoku Univ, Int Res Inst Disaster Sci, Div Int Cooperat Disaster Med, Sendai, Miyagi 980, Japan
关键词
Controlling Nutritional Status score; pancreatic exocrine insufficiency; pancrelipase; total pancreatectomy; hepatic steatosis; pancreatic enzyme replacement therapy; FATTY LIVER-DISEASE; RELEASE CAPSULES CREON; CHRONIC-PANCREATITIS; NONALCOHOLIC STEATOHEPATITIS; EXOCRINE INSUFFICIENCY; PANCREATICODUODENECTOMY; PANCRELIPASE; FIBROSIS; SURGERY; COMPLICATIONS;
D O I
10.1097/MPA.0000000000000462
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives 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.
引用
收藏
页码:362 / 369
页数:8
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