Impact of Fatty Pancreas on Postoperative Pancreatic Fistulae: A Meta-Analysis

Abstract

BackgroundSoft pancreas is widely recognized as an important risk factor for the development of postoperative pancreatic fistula (POPF). Although fatty pancreas (FP) has not been formally defined as a cause of pancreatic fistula, existing research has shown that it can increase the incidence of POPF by increasing pancreatic tenderness; therefore, it may be a potential risk factor. This study aimed to discern whether FP was associated with POPF.MethodTwo reviewers independently performed literature searches from five electronic databases. According to the established inclusion criteria, we extracted necessary data from the studies that met the criteria for further analysis. We pooled the odds ratios (ORs) from individual studies using a random-effects model to investigate the associations between POPF and the prognosis of FP.ResultA total of 11 studies involving 2484 individuals were included. The pooled prevalence of POPF was 18% (95% CI: 12-24%). Body mass index (BMI) was associated with a significantly increased risk of POPF (OR=3.55; 95% CI: 1.83, 6.86; P=0.0002; I²=0). FP was obviously associated with the occurrence of POPF (OR=3.75; 95% CI: 1.64, 8.58; P=0.002; I²=78).ConclusionFP is closely associated with the development of POPF, and the early identification of these high-risk patients can help to reduce the incidence of POPF.Systematic Review RegistrationThe Registration URL link is (https://www.crd.york.ac.uk/PROSPERO/). The ID is “CRD42021265141”.

Development and validation of a novel nomogram to predict postoperative pancreatic fistula after pancreatoduodenectomy using lasso-logistic regression: an international multi-institutional observational study

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Relationship between preoperative malnutrition, frailty, sarcopenia, body composition, and anthropometry in elderly patients undergoing major pancreatic and biliary surgery

“…From the perspective of body composition in the criteria, BMI may not be sensitive enough to be used in the surgical population, only 5.7% of cases were lower than 18.5 kg/m 2 , and nearly 40% of patients suffered from overweight and obesity, in which, nearly 20% were sarcopenia ( 7 ). Even in pancreatic surgery, higher BMI was treated as a risk factor for a fatty pancreas and postoperative pancreatic fistula rather than a nutrition parameter ( 30 ). FFMI and ASMI, which reflect the real change in muscle mass, had become the focus of diagnostic criteria.…”

Role of Pancreatic Attenuation Index in Assessing Pancreatic Fat Content and Postpancreatectomy Outcomes

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