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The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy

BACKGROUND: To study exocrine function of the remnant pancreas after pancreatoduodenectomy (PD), we propose the use of an exocrine index (PEI) that combines the volume of the remnant pancreas and the intraoperative amylase activity of the pancreatic juice. Here, we aimed to determine whether the PEI...

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Autores principales: Tsunematsu, Masashi, Gocho, Takeshi, Yanagaki, Mitsuru, Shirai, Yoshihiro, Haruki, Koichiro, Furukawa, Kenei, Yasuda, Jungo, Onda, Shinji, Sakamoto, Taro, Ikegami, Toru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444855/
https://www.ncbi.nlm.nih.gov/pubmed/36091315
http://dx.doi.org/10.1002/ags3.12572
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author Tsunematsu, Masashi
Gocho, Takeshi
Yanagaki, Mitsuru
Shirai, Yoshihiro
Haruki, Koichiro
Furukawa, Kenei
Yasuda, Jungo
Onda, Shinji
Sakamoto, Taro
Ikegami, Toru
author_facet Tsunematsu, Masashi
Gocho, Takeshi
Yanagaki, Mitsuru
Shirai, Yoshihiro
Haruki, Koichiro
Furukawa, Kenei
Yasuda, Jungo
Onda, Shinji
Sakamoto, Taro
Ikegami, Toru
author_sort Tsunematsu, Masashi
collection PubMed
description BACKGROUND: To study exocrine function of the remnant pancreas after pancreatoduodenectomy (PD), we propose the use of an exocrine index (PEI) that combines the volume of the remnant pancreas and the intraoperative amylase activity of the pancreatic juice. Here, we aimed to determine whether the PEI can predict non‐alcoholic fatty liver disease (NAFLD) following PD. METHODS: Fifty‐seven patients for whom pancreatic juice amylase activity was measured during PD were enrolled. NAFLD was defined as a liver‐to‐spleen attenuation ratio of <0.9 on plain CT 1 year following surgery. We retrospectively evaluated clinical parameters, including the PEI, to identify predictors of NAFLD. RESULTS: Fifty‐four patients (95%) were regularly administered 1200 mg of pancreatic lipase. NAFLD was diagnosed in 13 participants (23%) 1 year following surgery. NAFLD was associated with pancreatic ductal adenocarcinoma (P = .006), soft pancreas (P = .001), small main pancreatic duct (P = 0008), low remnant pancreatic volume (P < .001), low intraoperative amylase activity in the pancreatic juice (P = .001), high pancreatic fibrosis (P = .032), and large body weight loss (P = .015). The PEI was significantly lower in the participants with NAFLD than in those without (P < .001). The participants were then classified into tertiles of PEI: <5 × 10(6), 5‐25 × 10(6), and >25 × 10(6). The prevalence of NAFLD in these groups was 53% (10/19), 11% (2/19), and 5% (1/19), respectively. In multivariable analyses, there was a significant association between NAFLD and the PEI (P value for trend = .042). CONCLUSION: The PEI, calculated using the remnant pancreatic volume and the intraoperative pancreatic juice amylase activity, predicts NAFLD development following PD.
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spelling pubmed-94448552022-09-09 The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy Tsunematsu, Masashi Gocho, Takeshi Yanagaki, Mitsuru Shirai, Yoshihiro Haruki, Koichiro Furukawa, Kenei Yasuda, Jungo Onda, Shinji Sakamoto, Taro Ikegami, Toru Ann Gastroenterol Surg Original Articles BACKGROUND: To study exocrine function of the remnant pancreas after pancreatoduodenectomy (PD), we propose the use of an exocrine index (PEI) that combines the volume of the remnant pancreas and the intraoperative amylase activity of the pancreatic juice. Here, we aimed to determine whether the PEI can predict non‐alcoholic fatty liver disease (NAFLD) following PD. METHODS: Fifty‐seven patients for whom pancreatic juice amylase activity was measured during PD were enrolled. NAFLD was defined as a liver‐to‐spleen attenuation ratio of <0.9 on plain CT 1 year following surgery. We retrospectively evaluated clinical parameters, including the PEI, to identify predictors of NAFLD. RESULTS: Fifty‐four patients (95%) were regularly administered 1200 mg of pancreatic lipase. NAFLD was diagnosed in 13 participants (23%) 1 year following surgery. NAFLD was associated with pancreatic ductal adenocarcinoma (P = .006), soft pancreas (P = .001), small main pancreatic duct (P = 0008), low remnant pancreatic volume (P < .001), low intraoperative amylase activity in the pancreatic juice (P = .001), high pancreatic fibrosis (P = .032), and large body weight loss (P = .015). The PEI was significantly lower in the participants with NAFLD than in those without (P < .001). The participants were then classified into tertiles of PEI: <5 × 10(6), 5‐25 × 10(6), and >25 × 10(6). The prevalence of NAFLD in these groups was 53% (10/19), 11% (2/19), and 5% (1/19), respectively. In multivariable analyses, there was a significant association between NAFLD and the PEI (P value for trend = .042). CONCLUSION: The PEI, calculated using the remnant pancreatic volume and the intraoperative pancreatic juice amylase activity, predicts NAFLD development following PD. John Wiley and Sons Inc. 2022-04-25 /pmc/articles/PMC9444855/ /pubmed/36091315 http://dx.doi.org/10.1002/ags3.12572 Text en © 2022 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Tsunematsu, Masashi
Gocho, Takeshi
Yanagaki, Mitsuru
Shirai, Yoshihiro
Haruki, Koichiro
Furukawa, Kenei
Yasuda, Jungo
Onda, Shinji
Sakamoto, Taro
Ikegami, Toru
The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy
title The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy
title_full The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy
title_fullStr The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy
title_full_unstemmed The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy
title_short The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy
title_sort impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444855/
https://www.ncbi.nlm.nih.gov/pubmed/36091315
http://dx.doi.org/10.1002/ags3.12572
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