Key result
Visceral obesity was associated with significantly longer operative time, greater blood loss, and prolonged hospital stay, but did not significantly increase the rate of postoperative pancreatic fistula (45.83% vs 31.25%, p=0.402).
Why the study?
Obesity is associated with increased postsurgical morbidity and mortality, and measuring visceral obesity may predict postoperative outcomes following pancreaticoduodenectomy.
Does visceral obesity predict postoperative complications in patients undergoing pancreaticoduodenectomy?
Observational (n=56)
No
Does visceral obesity predict postoperative complications in patients undergoing pancreaticoduodenectomy?
Absolute Event Rate: 45.83% vs 31.25%
p-value: p=0.402
Visceral obesity, measured by retro-renal fat thickness on CT, is associated with increased operative time, blood loss, and length of hospital stay after pancreaticoduodenectomy.
Visceral obesity was associated with greater operative burden after pancreaticoduodenectomy; leaves open independent prediction of major complications.
INTRODUCTION: Obesity is associated with increased morbidity and mortality post surgery. The measurement of visceral obesity can predict postoperative outcomes after pancreaticoduodenectomy. METHODS: This is a prospective observational study. Visceral obesity was calculated by measuring the fat thickness in the retro-renal area by using a computed tomography scan. Visceral obesity was defined as retro-renal fat thickness (RRFT) of ≥ 2 cm. Patients were divided into two groups: Group-A (RRFT < 2 cm, non-obese) and Group-B (RRFT > 2 cm, obese). Demographic, clinical, and intraoperative variables were correlated with postoperative outcomes. RESULTS: Fifty-six patients were included in the study. Thirty-two patients were included in Group-A, and 24 patients were included in Group-B. The two groups had comparable outcomes. A total of 21 patients in Group-A (65.62%) and 17 patients in Group-B (70.83%) had comorbidities, including diabetes mellitus, hypertension, and coronary disease (p=0.680). American Society of Anesthesiologists (ASA) grading was comparable (p=0.927). BMI was also comparable (p=0.354). Type of pancreaticoduodenectomy, pancreatic texture, pancreatic duct diameter, and technique of pancreaticojejunostomy anastomosis were comparable. The mean operative time was longer in Group-B (362 ± 36.2 min vs. 298 ± 45.2 min) (p=0.001). Intraoperative blood loss was more in Group-B (312 ± 36.8 ml vs. 267 ± 23.7 ml) (p=0.001). The rates of postoperative pancreatic fistula and delayed gastric emptying were comparable (p=0.402 and p=0.134, respectively). The length of hospital stay was longer in patients in Group-B (p=0.004). There was one death in Group-B (obese group). CONCLUSION: Visceral obesity is a risk factor for postoperative complications after a pancreaticoduodenectomy.
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Ramavath et al. (2023) conducted an observational in Malignant pancreatic and periampullary tumors (n=56). Visceral obesity (retro-renal fat thickness ≥ 2 cm) vs. Non-obese (retro-renal fat thickness < 2 cm) was evaluated on Postoperative pancreatic fistula (POPF) (p=0.402). Visceral obesity was associated with significantly longer operative time, greater blood loss, and prolonged hospital stay, but did not significantly increase the rate of postoperative pancreatic fistula (45.83% vs 31.25%, p=0.402).
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