Barnes-Jewish Hospital at Washington University in St. Louis St. Louis, MO, United States
Vanisha Patel, MD, Parth Shah, MD, Motaz Ashkar, MBBS, MSCI, Daniel Ludwig, MD, Chet Hammill, MD, Greg Williams, Barnes-Jewish Hospital at Washington University in St. Louis, St. Louis, MO
Introduction: Nonalcoholic fatty liver disease (NAFLD) is increasingly reported as a post-operative finding in patients after pancreatectomy. However, disease mechanisms and risk factors remain unclear.
Methods: In this single-center retrospective analysis, 1798 patients underwent either distal pancreatectomy (DP) or pancreaticoduodenectomy (PD) between 2001-2020. Patients without pre-operative radiologic findings of NAFLD were included. Records were reviewed to diagnose hepatic steatosis with an average absolute hepatic attenuation of < 40 Hounsfield Units on pre- and post-operative unenhanced CT images.
Results: Based on pre-and post-operative imaging, 137 patients met inclusion criteria, of which 24 patients (17.5%) developed de novo NAFLD on average 2.2 years after pancreatectomy. The majority of patients that developed NAFLD were females (63%). Disease incidence was significantly higher in patients with malignant indications compared to benign indications for pancreatectomy (21.1% vs 9.5%, p=0.001). Pancreaticoduodenectomy was associated with the development of hepatic steatosis in 54% of cases. Majority of patients did not have pre-operative diabetes (69%). About 55.2% had current or prior history of smoking but 93.4% did not report significant alcohol use. NAFLD incidence was significantly linked to post-operative reduction in BMI (p=0.018).
Discussion: The incidence rate of de novo NAFLD in this study is comparable to prior studies. A background of a malignant indication for pancreatectomy, pancreaticoduodenectomy approach, and decrease in post-operative BMI may reflect accelerated malnutrition as a pathological mechanism of NAFLD in this cohort. By identifying risk factors for de novo NAFLD following pancreatectomy, this study could guide post-operative screening and management of these patients.
Disclosures: Vanisha Patel indicated no relevant financial relationships. Parth Shah indicated no relevant financial relationships. Motaz Ashkar indicated no relevant financial relationships. Daniel Ludwig indicated no relevant financial relationships. Chet Hammill indicated no relevant financial relationships. Greg Williams indicated no relevant financial relationships.
Vanisha Patel, MD, Parth Shah, MD, Motaz Ashkar, MBBS, MSCI, Daniel Ludwig, MD, Chet Hammill, MD, Greg Williams, . P1072 - Development of De Novo Nonalcoholic Fatty Liver Disease Following Pancreatectomy, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.