Retrospective Cohort Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2015; 21(23): 7218-7224
Published online Jun 21, 2015. doi: 10.3748/wjg.v21.i23.7218
Impact of body mass index on complications following pancreatectomy: Ten-year experience at National Cancer Center in China
Ying-Tai Chen, Qian Deng, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Ya-Wei Zhang, Cheng-Feng Wang
Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China
Qian Deng, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100075, China
Ya-Wei Zhang, Yale University School of Public Health, New Haven, CT 06520, United States
Author contributions: Chen YT, Che X and Zhang JW collected the clinical data; Deng Q and Chen YH carried out the statistical analyses; Zhao DB, Tian YT and Wang CF performed the operations; Chen YT and Zhang YW drafted and revised the manuscript.
Supported by National Natural Science Foundation of China, No. 81401947; the Specialized Research Fund for the Doctoral Program of Higher Education, No. 20131106120011; and The Cancer Hospital/Institute of the Chinese Academy of Medical Sciences, No. JK2011B13, Beijing Nova Program.
Ethics approval: The study was reviewed and approved by the Cancer Hospital of the Chinese Academy of Medical Sciences Institutional Review Board.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: The authors declare no competing financial interests.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yan-Tao Tian, MD, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, No. 17 Panjiayuan Nanli, Beijing 100021, China. tyt67@163.com
Telephone: +86-10-87787120 Fax: +86-10-67730386
Received: December 16, 2014
Peer-review started: December 17, 2014
First decision: January 22, 2015
Revised: February 1, 2015
Accepted: April 28, 2015
Article in press: April 28, 2015
Published online: June 21, 2015
Processing time: 185 Days and 20.4 Hours
Abstract

AIM: To examine the impact of body mass index (BMI) on outcomes following pancreatic resection in the Chinese population.

METHODS: A retrospective cohort study using prospectively collected data was conducted at the Cancer Hospital of the Chinese Academy of Medical Sciences, China National Cancer Center. Individuals who underwent pancreatic resection between January 2004 and December 2013 were identified and included in the study. Persons were classified as having a normal weight if their BMI was < 24 kg/m2 and overweight/obese if their BMI was ≥ 24 kg/m2 as defined by the International Life Sciences Institute Focal Point in China. A χ2 test (for categorical variables) or a t test (for continuous variables) was used to examine the differences in patients’ characteristics between normal weight and overweight/obese groups. Multiple logistic regression models were used to assess the associations of postoperative complications, operative difficulty, length of hospital stay, and cost with BMI, adjusting for age, sex, and type of surgery procedures.

RESULTS: A total of 362 consecutive patients with data available for BMI calculation underwent pancreatic resection for benign or malignant disease from January 1, 2004 to December 31, 2013. Of the 362 patients, 156 were overweight or obese and 206 were of normal weight. One or more postoperative complications occurred in 35.4% of the patients following pancreatic resection. Among patients who were overweight or obese, 42.9% experienced one or more complications, significantly higher than normal weight (29.6%) individuals (P = 0.0086). Compared with individuals who had normal weight, those with a BMI ≥ 24.0 kg/m2 had higher delayed gastric emptying (19.9% vs 5.8%, P < 0.0001) and bile leak (7.7% vs 1.9%, P = 0.0068). There were no significant differences seen in pancreatic fistula, gastrointestinal hemorrhage, reoperation, readmission, or other complications. BMI did not show a significant association with intraoperative blood loss, operative time, length of hospital stay, or cost.

CONCLUSION: Higher BMI increases the risk for postoperative complications after pancreatectomy in the Chinese population. The findings require replication in future studies with larger sample sizes.

Keywords: Body mass index; China; Pancreatectomy; Pancreatic cancer; Postoperative complications

Core tip: The influence of body mass index on post-surgical complications after pancreatectomy remains controversial. Moreover, a majority of these studies were conducted in Western countries. This study was conducted to examine the associations between body mass index and complications after pancreatectomy in a cohort of Chinese patients.