The impact of postoperative exocrine index on non‐alcoholic fatty liver disease following pancreaticoduodenectomy

Abstract

Abstract Background To study exocrine function of the remnant pancreas after pancreatoduodenectomy (PD), we propose the use of an exocrine index (PEI) that combines the volume of the remnant pancreas and the intraoperative amylase activity of the pancreatic juice. Here, we aimed to determine whether the PEI can predict non‐alcoholic fatty liver disease (NAFLD) following PD. Methods Fifty‐seven patients for whom pancreatic juice amylase activity was measured during PD were enrolled. NAFLD was defined as a liver‐to‐spleen attenuation ratio of 25 × 106. The prevalence of NAFLD in these groups was 53% (10/19), 11% (2/19), and 5% (1/19), respectively. In multivariable analyses, there was a significant association between NAFLD and the PEI (P value for trend = .042). Conclusion The PEI, calculated using the remnant pancreatic volume and the intraoperative pancreatic juice amylase activity, predicts NAFLD development following PD.

Keywords

• diabetes mellitus
• exocrine index
• non‐alcoholic fatty liver disease
• pancreatic juice
• pancreaticoduodenectomy