Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2025; 31(13): 104046
Published online Apr 7, 2025. doi: 10.3748/wjg.v31.i13.104046
Nonalcoholic fatty liver disease following laparoscopic duodenum-preserving pancreatic total head resection vs laparoscopic pancreaticoduodenectomy: A retrospective cohort study
Ting-Ting Zhen, Shi-Zhen Li, Shu-Tao Pan, Tao-Yuan Yin, Min Wang, Xing-Jun Guo, Hang Zhang, Ren-Yi Qin
Ting-Ting Zhen, Shi-Zhen Li, Shu-Tao Pan, Tao-Yuan Yin, Min Wang, Xing-Jun Guo, Hang Zhang, Ren-Yi Qin, Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Co-corresponding authors: Hang Zhang and Ren-Yi Qin.
Author contributions: Zhen TT, Li SZ collected data, performed statistical analysis, and wrong the original draft; Pan ST, Yin TY, Wang M reviewed and edited the manuscript; Guo XJ, Zhang H, Qin RY designed the research study, funding acquisition, technical or material support. The decision to designate Dr. Qin and Dr. Zhang as co-corresponding authors is well-justified, as both made indispensable and complementary contributions to the research and its successful publication. Dr. Qin’s leadership in designing the research methodology, particularly in integrating surgical approaches with non-alcoholic fatty liver disease research, was foundational to the study’s innovative direction. Furthermore, Dr. Qin’s efforts in securing essential funding were critical to initiating and sustaining the project, ensuring its feasibility and continuity. On the other hand, Dr. Zhang’s meticulous review of the first draft and his provision of detailed, constructive feedback were pivotal in refining the manuscript. His insights ensured that the paper adhered to rigorous disciplinary standards and met the stringent requirements for publication. Together, their combined expertise and efforts advanced the research and enhanced its quality and impact.
Supported by National Natural Science Foundation of China, No. 82273442.
Institutional review board statement: This retrospective cohort study was reviewed and approved by the Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. TJ-IRB202401014.
Informed consent statement: The requirement for patient consent was waived owing to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data supporting this study's findings are available from the author, Ting-Ting Zhen, upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ren-Yi Qin, PhD, Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. ryqin@tjh.tjmu.edu.cn
Received: December 11, 2024
Revised: February 21, 2025
Accepted: March 10, 2025
Published online: April 7, 2025
Processing time: 114 Days and 2.2 Hours
Abstract
BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is characterized by the accumulation of fat in the liver in individuals who do not consume alcohol. Several risk factors influencing the onset of NAFLD after laparoscopic pancreaticoduodenectomy (LPD) have been identified. This study investigated the risk factors associated with the development of fatty liver after laparoscopic duodenum-preserving pancreatic total head resection (LDPPHRt) and LPD.

AIM

To compare the effects of LDPPHRt and LPD on the development of postoperative NAFLD.

METHODS

This retrospective cohort study included 59 patients who were histologically diagnosed with benign or low-grade malignant pancreatic tumors and who underwent laparoscopic pancreatic surgery (LDPPHRt or LPD) between May 2020 and April 2023. Patient data on perioperative and postoperative variables were analyzed and compared. Multivariate logistic regression was used to identify pre-, peri-, and postoperative risk factors for NAFLD, with statistical significance set at P < 0.05.

RESULTS

Of the 59 patients included in the study, 17 (28.8%) developed NAFLD within 6-12 months post-surgery. The incidence of NAFLD was significantly higher in the LPD group compared to the LDPPHRt group (40.0% vs 12.5%, P = 0.022). Multivariable analysis identified the LDPPHRt surgical approach (compared to LPD) as an independent protective factor against the development of postoperative NAFLD, with an odds ratio of 0.208 (95% confidence interval: 0.046-0.931; P = 0.040).

CONCLUSION

Our findings indicate that LDPPHRt is more effective than LPD in reducing the incidence of postoperative NAFLD, which may inform surgical decision-making and optimize patient outcomes after laparoscopic pancreatic surgery.

Keywords: Non-alcoholic fatty liver disease; Laparoscopic duodenum-preserving pancreatic total head resection; Laparoscopic pancreaticoduodenectomy; Malnutrition; Insulin resistance

Core Tip: Our study demonstrates that laparoscopic pancreatic total head resection with preservation of the duodenum is more effective than laparoscopic pancreatic head duodenectomy in preventing postoperative nonalcoholic fatty liver disease. In addition, we identified the factors associated with the development of fatty liver after pancreatic surgery.