Obesity does not increase complications following pancreatic surgery

Courtney J. Balentine, Jose Enriquez, Guillermina Cruz, Sally Hodges, Vivek Bansal, Eunji Jo, Charlotte Ahern, Shubhada Sansgiry, Nancy Petersen, Eric Silberfein, F. Charles Brunicardi, David H. Berger, William Fisher

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Background: Recent evidence suggests that the quantity of intra-abdominal fat may be a more important predictor of postoperative complications than body mass index (BMI). We hypothesized that increased intra-abdominal fat would be associated with longer operations, increased blood loss, more complications, and prolonged length of stay after pancreatic resection. Methods: Retrospective cohort study. Intra-abdominal fat was quantified using CT imaging, and patients were divided into three groups (low, moderate, high). Unconditional multiple logistic regression was used to evaluate the relationship between obesity measures and complications. Results: Between 2002 and 2010, 255 patients underwent pancreaticoduodenectomy or distal pancreatectomy, and 201 had preoperative CT imaging available for review. Operative time was significantly prolonged in patients with high quantities of intra-abdominal fat compared with those with low fat quantity (median 438 versus 354 min, P < 0.05), while BMI was not associated with changes in duration of surgery. Neither obesity defined by BMI (OR 0.90, 95% CI 0.36-2.21) nor visceral fat (OR 1.20, 95% CI 0.46-3.16) significantly predicted risk of complications. Median length of stay was similar in patients who were obese by BMI (7 versus 7.5 d) or amount of intra-abdominal fat (7 d). Conclusions: Intra-abdominal fat was a better predictor than BMI for determining length of procedure. However, in contrast to previous studies evaluating abdominal surgery, neither BMI nor intra-abdominal fat significantly predicted risk of complication or length of hospital stay. Further research is needed to determine the best measure to assist in risk prediction of obese patients undergoing pancreatic surgery.

Original languageEnglish (US)
Pages (from-to)220-225
Number of pages6
JournalJournal of Surgical Research
Volume170
Issue number2
DOIs
StatePublished - Oct 1 2011
Externally publishedYes

Keywords

  • obesity
  • pancreas surgery
  • pancreatic surgery

ASJC Scopus subject areas

  • Surgery

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    Balentine, C. J., Enriquez, J., Cruz, G., Hodges, S., Bansal, V., Jo, E., Ahern, C., Sansgiry, S., Petersen, N., Silberfein, E., Brunicardi, F. C., Berger, D. H., & Fisher, W. (2011). Obesity does not increase complications following pancreatic surgery. Journal of Surgical Research, 170(2), 220-225. https://doi.org/10.1016/j.jss.2011.03.048