Risk factors of developing nonalcoholic fatty liver disease after pancreatic resection: a systematic review and meta-analysis.
Publication/Presentation Date
6-1-2024
Abstract
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) occurs in 10% to 40% of patients after pancreatic resection. Pancreatic exocrine insufficiency (PEI) is thought to be closely associated with NAFLD; however, the mechanism of NAFLD is not clearly understood. We perform a systematic review and meta-analysis to better understand the risk factors of NAFLD.
METHODS: A systematic literature search was performed in the MEDLINE database. Studies focused on the risk factors associated with NAFLD in patients undergoing pancreatectomy. The odds ratios (ORs) denoting the association of risk factors with NAFLD after resection were curated.
RESULTS: Of 814 published articles, 26 studies met the inclusion criteria. Combined, these studies included clinical data on 4055 patients. The pooled incidence of NAFLD was 29% (23%-35%). Among the various risk factors analyzed, the following had a significant likelihood of NAFLD on forest plot analysis: female gender (OR, 2.44), pancreatic ductal adenocarcinoma (OR, 2.11), portal vein or superior mesenteric vein resection (OR, 1.99), dissection of nerve plexus around the superior mesenteric artery (OR, 1.93), and adjuvant chemotherapy (OR, 1.58). Only 2 studies investigated 2 different measurements of quantitative PEI, which could not be used for analysis. Owing to heterogeneity of studies, pancreatic remanent volume, which is considered a marker for PEI could not be evaluated. Pancreatic enzyme replacement therapy (PERT) was not associated with NAFLD.
CONCLUSION: Numerous factors are associated with NAFLD after pancreatectomy. Previous research shows that PEI may be associated with NAFLD; however, this could not be compared in our meta-analysis. Further research is required to study the role of PERT in NAFLD.
Volume
28
Issue
6
First Page
983
Last Page
992
ISSN
1873-4626
Published In/Presented At
Sugumar, K., Naik, L., Hue, J. J., Ammori, J. B., Hardacre, J. M., Ocuin, L. M., & Winter, J. M. (2024). Risk factors of developing nonalcoholic fatty liver disease after pancreatic resection: a systematic review and meta-analysis. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 28(6), 983–992. https://doi.org/10.1016/j.gassur.2024.03.025
Disciplines
Medicine and Health Sciences
PubMedID
38552899
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article
