Preoperative predictors for complications after pancreaticoduodenectomy

Impact of BMI and body fat distribution

Michael House, Yuman Fong, Dean J. Arnaoutakis, Rohit Sharma, Corinne B. Winston, Mladjan Protic, Mithat Gonen, Sara H. Olson, Robert C. Kurtz, Murray F. Brennan, Peter J. Allen

Research output: Contribution to journalArticle

177 Citations (Scopus)

Abstract

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 Aden carcinoma 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 retro renal visceral fat (VF). Complications occurred in 51% of patients with VF≥2 cm, compared to 31% of patients with VF2 compared to 12% of the no obese 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.

Original languageEnglish (US)
Pages (from-to)270-278
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume12
Issue number2
DOIs
StatePublished - 2008
Externally publishedYes

Fingerprint

Body Fat Distribution
Pancreaticoduodenectomy
Pancreatic Fistula
Intra-Abdominal Fat
Yemen
Surgical Wound Infection
Abdominal Obesity
Gastric Emptying
Wound Infection
Abscess
Atrophy
Multivariate Analysis
Obesity
Morbidity
Kidney

Keywords

  • Complications
  • Obesity
  • Pancreaticoduodenectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Preoperative predictors for complications after pancreaticoduodenectomy : Impact of BMI and body fat distribution. / House, Michael; Fong, Yuman; Arnaoutakis, Dean J.; Sharma, Rohit; Winston, Corinne B.; Protic, Mladjan; Gonen, Mithat; Olson, Sara H.; Kurtz, Robert C.; Brennan, Murray F.; Allen, Peter J.

In: Journal of Gastrointestinal Surgery, Vol. 12, No. 2, 2008, p. 270-278.

Research output: Contribution to journalArticle

House, M, Fong, Y, Arnaoutakis, DJ, Sharma, R, Winston, CB, Protic, M, Gonen, M, Olson, SH, Kurtz, RC, Brennan, MF & Allen, PJ 2008, 'Preoperative predictors for complications after pancreaticoduodenectomy: Impact of BMI and body fat distribution', Journal of Gastrointestinal Surgery, vol. 12, no. 2, pp. 270-278. https://doi.org/10.1007/s11605-007-0421-7
House, Michael ; Fong, Yuman ; Arnaoutakis, Dean J. ; Sharma, Rohit ; Winston, Corinne B. ; Protic, Mladjan ; Gonen, Mithat ; Olson, Sara H. ; Kurtz, Robert C. ; Brennan, Murray F. ; Allen, Peter J. / Preoperative predictors for complications after pancreaticoduodenectomy : Impact of BMI and body fat distribution. In: Journal of Gastrointestinal Surgery. 2008 ; Vol. 12, No. 2. pp. 270-278.
@article{cf820940ae9f48aaa914569f45e2203d,
title = "Preoperative predictors for complications after pancreaticoduodenectomy: Impact of BMI and body fat distribution",
abstract = "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 Aden carcinoma 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 retro renal visceral fat (VF). Complications occurred in 51{\%} of patients with VF≥2 cm, compared to 31{\%} of patients with VF2 compared to 12{\%} of the no obese 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.",
keywords = "Complications, Obesity, Pancreaticoduodenectomy",
author = "Michael House and Yuman Fong and Arnaoutakis, {Dean J.} and Rohit Sharma and Winston, {Corinne B.} and Mladjan Protic and Mithat Gonen and Olson, {Sara H.} and Kurtz, {Robert C.} and Brennan, {Murray F.} and Allen, {Peter J.}",
year = "2008",
doi = "10.1007/s11605-007-0421-7",
language = "English (US)",
volume = "12",
pages = "270--278",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Preoperative predictors for complications after pancreaticoduodenectomy

T2 - Impact of BMI and body fat distribution

AU - House, Michael

AU - Fong, Yuman

AU - Arnaoutakis, Dean J.

AU - Sharma, Rohit

AU - Winston, Corinne B.

AU - Protic, Mladjan

AU - Gonen, Mithat

AU - Olson, Sara H.

AU - Kurtz, Robert C.

AU - Brennan, Murray F.

AU - Allen, Peter J.

PY - 2008

Y1 - 2008

N2 - 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 Aden carcinoma 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 retro renal visceral fat (VF). Complications occurred in 51% of patients with VF≥2 cm, compared to 31% of patients with VF2 compared to 12% of the no obese 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.

AB - 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 Aden carcinoma 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 retro renal visceral fat (VF). Complications occurred in 51% of patients with VF≥2 cm, compared to 31% of patients with VF2 compared to 12% of the no obese 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.

KW - Complications

KW - Obesity

KW - Pancreaticoduodenectomy

UR - http://www.scopus.com/inward/record.url?scp=47749104577&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=47749104577&partnerID=8YFLogxK

U2 - 10.1007/s11605-007-0421-7

DO - 10.1007/s11605-007-0421-7

M3 - Article

VL - 12

SP - 270

EP - 278

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 2

ER -