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Preoperative predictors for complications after pancreaticoduodenectomy: impact of BMI and body fat distribution.

Publication ,  Journal Article
House, MG; Fong, Y; Arnaoutakis, DJ; Sharma, R; Winston, CB; Protic, M; Gonen, M; Olson, SH; Kurtz, RC; Brennan, MF; Allen, PJ
Published in: J Gastrointest Surg
February 2008

BACKGROUND: The purpose of this study was to examine the preoperative patient and radiographic factors that are associated with operative morbidity after pancreaticoduodenectomy. MATERIAL AND METHODS: Patient characteristics and preoperative radiographic findings and their association with postoperative complications after pancreaticoduodenectomy were analyzed for 356 patients with pancreatic adenocarcinoma who underwent resection between 2000 and 2005. RESULTS: Postoperative complications developed in 135 patients (38%). The most common complications were pancreatic fistula/abscess (15%), wound infection (14%), and delayed gastric emptying (4%). On multivariate analysis, the only preoperative radiographic factors associated with having any postoperative complication were the absence of pancreatic atrophy and the extent of central obesity determined by the thickness of retrorenal visceral fat (VF). Complications occurred in 51% of patients with VF > or = 2 cm, compared to 31% of patients with VF < 2 cm, p < 0.001. Postoperatively, pancreatic fistula developed in 24% of patients with VF > or = 2 cm and in only 10% of patients with VF < 2 cm, p = 0.01. Wound infections occurred in 21% of the patients with body mass index greater than or equal to 30 kg/m(2) compared to 12% of the nonobese patients, p = 0.03. CONCLUSIONS: Generalized obesity is associated with postoperative wound infections after pancreaticoduodenectomy. The degree of visceral fat on preoperative cross-sectional imaging is associated with significantly higher rates of overall complications and pancreatic fistula.

Duke Scholars

Published In

J Gastrointest Surg

DOI

ISSN

1091-255X

Publication Date

February 2008

Volume

12

Issue

2

Start / End Page

270 / 278

Location

Netherlands

Related Subject Headings

  • Surgical Wound Infection
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Radiography
  • Postoperative Complications
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Pancreatic Fistula
  • Multivariate Analysis
 

Citation

APA
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House, M. G., Fong, Y., Arnaoutakis, D. J., Sharma, R., Winston, C. B., Protic, M., … Allen, P. J. (2008). Preoperative predictors for complications after pancreaticoduodenectomy: impact of BMI and body fat distribution. J Gastrointest Surg, 12(2), 270–278. https://doi.org/10.1007/s11605-007-0421-7
House, Michael G., Yuman Fong, Dean J. Arnaoutakis, Rohit Sharma, Corinne B. Winston, Mladjan Protic, Mithat Gonen, et al. “Preoperative predictors for complications after pancreaticoduodenectomy: impact of BMI and body fat distribution.J Gastrointest Surg 12, no. 2 (February 2008): 270–78. https://doi.org/10.1007/s11605-007-0421-7.
House MG, Fong Y, Arnaoutakis DJ, Sharma R, Winston CB, Protic M, et al. Preoperative predictors for complications after pancreaticoduodenectomy: impact of BMI and body fat distribution. J Gastrointest Surg. 2008 Feb;12(2):270–8.
House, Michael G., et al. “Preoperative predictors for complications after pancreaticoduodenectomy: impact of BMI and body fat distribution.J Gastrointest Surg, vol. 12, no. 2, Feb. 2008, pp. 270–78. Pubmed, doi:10.1007/s11605-007-0421-7.
House MG, Fong Y, Arnaoutakis DJ, Sharma R, Winston CB, Protic M, Gonen M, Olson SH, Kurtz RC, Brennan MF, Allen PJ. Preoperative predictors for complications after pancreaticoduodenectomy: impact of BMI and body fat distribution. J Gastrointest Surg. 2008 Feb;12(2):270–278.
Journal cover image

Published In

J Gastrointest Surg

DOI

ISSN

1091-255X

Publication Date

February 2008

Volume

12

Issue

2

Start / End Page

270 / 278

Location

Netherlands

Related Subject Headings

  • Surgical Wound Infection
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Radiography
  • Postoperative Complications
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Pancreatic Fistula
  • Multivariate Analysis