New onset non‐alcoholic fatty liver disease after resection of pancreatic neuroendocrine tumors

BACKGROUND AND OBJECTIVES: Non‐alcoholic fatty liver disease (NAFLD) and non‐alcoholic steatohepatis (NASH) may occur after pancreatic resection due to exocrine pancreatic insufficiency (EPI). Patients with long‐term survival, such as after pancreatic neuroendocrine tumor (pNET) resection, are at risk of NAFLD/NASH. We aimed to determine the incidence and risk factors for new onset NAFLD/NASH and EPI after pNET resection. METHODS: Retrospective monocenter cohort study. Patients who underwent pNET resection (1992‐2016) were assessed for new onset NAFLD/NASH and EPI. Postoperative NAFLD/NASH was determined by a blinded abdominal radiologist, who compared pre‐ and postoperative imaging. RESULTS: Out of 235 patients with pNET, a total of 112 patients underwent resection and were included with a median follow‐up of 54 months. New onset NAFLD/NASH occurred in 20% and EPI in 49% of patients. Multivariate analysis showed that the only risk factor for new onset NAFLD/NASH was recurrent disease (OR 4.4, 95% CI 1.1‐16.8, P = 0.031), but not EPI (OR 0.94, 95% CI 0.3‐2.8, P = 0.911). The only risk factor for EPI was pancreatoduodenectomy (OR 4.3, 95% CI 1.4‐13.7, P = 0.012). CONCLUSIONS: New onset NAFLD/NASH is occasionally found after pNET resection, especially in patients with recurrent disease, but is not related to EPI.