Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Saturday, 10 / 16 / 2021

Abstract

Identification of Nonalcoholic Fatty Liver Disease following Pancreatic Surgery in a Western Cohort Using a Novel Radiographic Technique

Sidney Olefson1, Melissa Jackson1, David J. Grand2, Kevin P. Charpentier3, Nirav Makwana2 and Kittichai Promrat*4

1Department of Internal Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; 2Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI, USA; 3Department of Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA; 4Division of Gastroenterology and Hepatology, Warren Alpert Medical School of Brown University, Providence, RI, USA

Abstract

Background and Aims: While traditional risk factors for the development of nonalcoholic fatty liver disease (NAFLD) relate to metabolic syndrome, several Asian studies have suggested a high rate of de novo NAFLD following pancreaticoduodenectomy (PD). The aim of this study is to identify de novo NAFLD after pancreatic surgery and its associated risk factors. Methods: A retrospective cohort of patients at a single center that underwent PD or distal pancreatectomy (DP) over 7 years was identified. Pre- and postoperative contrast-enhanced computed tomography scans of the abdomen were reviewed, including attenuation measurements of the liver, spleen, and muscle. Primary outcomes included hepatic attenuation, liver to muscle ratio (LMR), and liver to spleen ratio (LSR). Results: Of the 96 patients (mean age 64.3) included, 70% underwent PD, and 30% underwent DP. The mean LMR decreased significantly from 1.81 to 1.66 (p=0.02), noted only in men. No interaction effect with LMR was observed with surgical type, chemotherapy, blood loss, pancreatic enzyme replacement, or transaminases. LMR decreased in 55% of subjects. Conclusions: Increased fatty infiltration, as evidence by decreased LMR, was found among men that underwent PD and DP within a year of surgery. This may be related to weight loss and malabsorption and deserves further investigation.

Doi: 10.14218/JCTH.2015.00029
Journal of Clinical and Translational Hepatology 2015 vol. 3, 246-253  [
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