TY - JOUR
T1 - Obesity does not increase complications following pancreatic surgery
AU - Balentine, Courtney J.
AU - Enriquez, Jose
AU - Cruz, Guillermina
AU - Hodges, Sally
AU - Bansal, Vivek
AU - Jo, Eunji
AU - Ahern, Charlotte
AU - Sansgiry, Shubhada
AU - Petersen, Nancy
AU - Silberfein, Eric
AU - Brunicardi, F. Charles
AU - Berger, David H.
AU - Fisher, William
N1 - Funding Information:
This work was supported in part by the Houston VA HSR&D Center of Excellence ( HFP90-020 ). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
PY - 2011/10
Y1 - 2011/10
N2 - 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.
AB - 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.
KW - obesity
KW - pancreas surgery
KW - pancreatic surgery
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U2 - 10.1016/j.jss.2011.03.048
DO - 10.1016/j.jss.2011.03.048
M3 - Article
C2 - 21514600
AN - SCOPUS:80052792338
SN - 0022-4804
VL - 170
SP - 220
EP - 225
JO - Journal of Surgical Research
JF - Journal of Surgical Research
IS - 2
ER -