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Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy
AIM: To analyze immediate postoperative outcomes after pancreaticoduodenectomy regarding metabolic syndrome. METHODS: In two academic centers, postoperative outcomes of patients undergoing pancreaticoduodenectomy from 2002 to 2014 were prospectively recorded. Patients presenting with metabolic syndr...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423051/ https://www.ncbi.nlm.nih.gov/pubmed/28533671 http://dx.doi.org/10.3748/wjg.v23.i17.3142 |
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author | Zarzavadjian Le Bian, Alban Fuks, David Chopinet, Sophie Gaujoux, Sébastien Cesaretti, Manuela Costi, Renato Belgaumkar, Ajay P Smadja, Claude Gayet, Brice |
author_facet | Zarzavadjian Le Bian, Alban Fuks, David Chopinet, Sophie Gaujoux, Sébastien Cesaretti, Manuela Costi, Renato Belgaumkar, Ajay P Smadja, Claude Gayet, Brice |
author_sort | Zarzavadjian Le Bian, Alban |
collection | PubMed |
description | AIM: To analyze immediate postoperative outcomes after pancreaticoduodenectomy regarding metabolic syndrome. METHODS: In two academic centers, postoperative outcomes of patients undergoing pancreaticoduodenectomy from 2002 to 2014 were prospectively recorded. Patients presenting with metabolic syndrome [defined as at least three criteria among overweight (BMI ≥ 28 kg/m²), diabetes mellitus, arterial hypertension and dyslipidemia] were compared to patients without metabolic syndrome. RESULTS: Among 270 consecutive patients, 29 (11%) presented with metabolic syndrome. In univariable analysis, patients with metabolic syndrome were significantly older (69.4 years vs 62.5 years, P = 0.003) and presented more frequently with soft pancreas (72% vs 22%, P = 0.0001). In-hospital morbidity (83% vs 71%) and mortality (7% vs 6%) did not differ in the two groups so as pancreatic fistula rate (45% vs 30%, P = 0.079) and severity of pancreatic fistula (P = 0.257). In multivariable analysis, soft pancreas texture (P = 0.001), pancreatic duct diameter < 3 mm (P = 0.025) and BMI > 30 kg/m² (P = 0.041) were identified as independent risk factors of pancreatic fistula after pancreaticoduodenectomy, but not metabolic syndrome. CONCLUSION: In spite of logical reasoning and appropriate methodology, present series suggests that metabolic syndrome does not jeopardize postoperative outcomes after pancreaticoduodenectomy. Therefore, definition of metabolic syndrome seems to be inappropriate and fatty pancreas needs to be assessed with an international consensual histopathological classification. |
format | Online Article Text |
id | pubmed-5423051 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-54230512017-05-22 Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy Zarzavadjian Le Bian, Alban Fuks, David Chopinet, Sophie Gaujoux, Sébastien Cesaretti, Manuela Costi, Renato Belgaumkar, Ajay P Smadja, Claude Gayet, Brice World J Gastroenterol Observational Study AIM: To analyze immediate postoperative outcomes after pancreaticoduodenectomy regarding metabolic syndrome. METHODS: In two academic centers, postoperative outcomes of patients undergoing pancreaticoduodenectomy from 2002 to 2014 were prospectively recorded. Patients presenting with metabolic syndrome [defined as at least three criteria among overweight (BMI ≥ 28 kg/m²), diabetes mellitus, arterial hypertension and dyslipidemia] were compared to patients without metabolic syndrome. RESULTS: Among 270 consecutive patients, 29 (11%) presented with metabolic syndrome. In univariable analysis, patients with metabolic syndrome were significantly older (69.4 years vs 62.5 years, P = 0.003) and presented more frequently with soft pancreas (72% vs 22%, P = 0.0001). In-hospital morbidity (83% vs 71%) and mortality (7% vs 6%) did not differ in the two groups so as pancreatic fistula rate (45% vs 30%, P = 0.079) and severity of pancreatic fistula (P = 0.257). In multivariable analysis, soft pancreas texture (P = 0.001), pancreatic duct diameter < 3 mm (P = 0.025) and BMI > 30 kg/m² (P = 0.041) were identified as independent risk factors of pancreatic fistula after pancreaticoduodenectomy, but not metabolic syndrome. CONCLUSION: In spite of logical reasoning and appropriate methodology, present series suggests that metabolic syndrome does not jeopardize postoperative outcomes after pancreaticoduodenectomy. Therefore, definition of metabolic syndrome seems to be inappropriate and fatty pancreas needs to be assessed with an international consensual histopathological classification. Baishideng Publishing Group Inc 2017-05-07 2017-05-07 /pmc/articles/PMC5423051/ /pubmed/28533671 http://dx.doi.org/10.3748/wjg.v23.i17.3142 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Observational Study Zarzavadjian Le Bian, Alban Fuks, David Chopinet, Sophie Gaujoux, Sébastien Cesaretti, Manuela Costi, Renato Belgaumkar, Ajay P Smadja, Claude Gayet, Brice Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy |
title | Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy |
title_full | Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy |
title_fullStr | Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy |
title_full_unstemmed | Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy |
title_short | Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy |
title_sort | consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy |
topic | Observational Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423051/ https://www.ncbi.nlm.nih.gov/pubmed/28533671 http://dx.doi.org/10.3748/wjg.v23.i17.3142 |
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