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Hepatic Steatosis Following Pancreatic Surgery: A Swedish Centers Experience with Demographics, Risks and Outcome

Objective Non-alcoholic fatty liver disease encompasses a spectrum of fatty changes in the liver ranging from simple steatosis to nonalcoholic steatohepatitis. Certain patients may develop hepatic steatosis following pancreatic resections. The aim of our study was to investigate factors possibly associated with steatosis after pancreatic resection and to see if the survival of patients was influenced by its development. Methods 182 consecutive patients that underwent pancreatic surgery (between 2010-2013) in a Swedish high volume pancreatic center were retrospectively reviewed from the preoperative work-up until at least 6 months postoperatively. Pre-versus postoperative values of Hounsfield Units were checked on CT scans and utilized as a proxy for development of hepatic steatosis. Demographic data and a number of possible risk factors were recorded together with survival after surgery. Results 17 percent of our patient group developed hepatic steatosis within the first year of surgery. The development of steatosis occurred significantly more frequently in females and in patients over the age of 70. Hepatic steatosis was positively associated with increased levels of alanine amino transferase (ALT) after surgery. No association was noted between grade of weight loss and steatosis. Nor were there any correlations between the incidence of steatosis and the type of operation. Post-operative hepatic steatosis did not adversely affect overall survival. Conclusion Our results demonstrate that certain demographic and laboratory values are associated with the development of hepatic steatosis after pancreatic resections. However, despite its development, hepatic steatosis is of no apparent clinical significance and does not affect overall survival following pancreatic surgery.

Author(s): Tommy Ivanics, Srinivas Sanjeevi, Christoph Ansorge, Åke Andrén-Sandberg

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