Surgery, Gastroenterology and Oncology

Background: Although hepatic steatosis is often observed after pancreatoduodenectomy (PD), its preoperative clinical features remain unclear. This study focused on the risk factors for non-alcoholic fatty liver disease (NAFLD) after PD.

Methotology: Between April 2008 and June 2011, 100 patients underwent subtotal stomach-preserving PD (SSPPD) for pancreatic head or periampullary diseases. We divided the patients into two groups: a NAFLD group (NA group) and a non-NAFLD group (non-NA group). We compared risk factors such as BMI, blood parameters, blood cell count and trace elements (Fe, Zn, Cu and pre-albumin) in the serum between the two groups. NAFLD was defined as being present when the HU value was less than 40 or when the spleen liver HU ratio was more than 1.5 on the basis of abdominal CT three months after surgery.

Results: Twenty-seven of the 100 (27.0%) patients had NAFLD within three months after surgery. Univariate analysis selected age, reconstruction for Gastrojejunostomy, the preoperative Alb, AST, ALT, Fe, and Zn levels as risk factors for NAFLD. At multivariate analyses, only preoperative Fe level was a risk factor for NAFLD (odd ratio1.052; 95% C.I.1.457- 29.663; p=0.034). Conclusions: Preoperative serum Fe level is the only independent risk factor for NAFLD after PD.

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