The impact of body mass index on pancreatic fistula after pancreaticoduodenectomy in Asian patients on the basis of Asia-Pacific perspective of body mass index

Abstract

CONTEXT: Several surgical complications are related to obesity.

OBJECTIVE: This study evaluated the impact of obesity on pancreatic fistula after pancreaticoduodenectomy.

DESIGN: We retrospectively reviewed the medical records of 159 patients who underwent pancreaticoduodenectomy between October 2002 and December 2008.

SETTING: The patients were divided according to the body mass index as obese (body mass index equal to, or greater than, 25 kg/m(2)), or normal (body mass index less than 25 kg/m(2)).

METHODS: Univariate and multivariate analyses were applied. Two-tailed P values less than 0.05 were considered as significant.

RESULTS: Forty-six patients (28.9%) were obese and 113 patients (71.1%) were normal-weight. Obese group had a significantly higher incidence of pancreatic fistula and a greater amount of intraoperative blood loss. Other surgical complications were not significantly different between the two groups. Multivariate analysis found obesity, small pancreatic duct size (less than, or equal to, 3 mm), intraoperative blood loss, and combined resection as significant factors affecting pancreatic fistula.

CONCLUSIONS: Obese patients have an increased risk for pancreatic fistula after pancreaticoduodenectomy.