Incidence and Longitudinal Trajectory of de novo Hepatic Steatosis after Pancreatoduodenectomy: A Prospective Cohort Study Using Transient Elastography

Background/Aims: hepatic steatosis after PD using vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP). Methods: hepatic steatosis was defined as CAP ≥275 dB/m on follow-up VCTE. Assessments were performed at 6, 12, 18, and 24 months after surgery. The primary outcome was cumulative incidence at 12 months. Results: ; 95% CI, 1.13 to 1.76; p=0.003). Conclusions: hepatic steatosis developed in approximately one-quarter of patients after PD and showed a partially reversible course. Higher preoperative body mass index and adjuvant chemotherapy independently predicted its development, supporting systematic postoperative hepatic surveillance using VCTE.