Detailed Abstract
[Plenary Session]
[PL 3] Effect of high-dose pancreatic enzyme replacement on prevention of postpancreatectomy hepatic steatosis after pancreatoduodenectomy: A prospective cohort study
Moonhwan KIM1, Yoo-Seok YOON*1, JIn-Young JANG2, Wooil KWON2, Hongbeom KIM2, Dong-Sup YOON3, Joon Seong PARK3, Seung Eun LEE4, Jun Suh LEE1, Ho-Seong HAN1
1Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine,Seoul, Korea
2Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea, Korea
3Surgery, Gangnam Severance Hospital, Seoul, Afghanistan
4Surgery, Chung-Ang University Hospital, Seoul, Korea
Introduction : Postpancreatectomy hepatic steatosis (PHS) is a long-term complication of pancreaticoduodenectomy (PD), which has been not well noticed. The aim of this study was to evaluate the effect of high-dose pancreatic enzyme replacement therapy (HPERT) on prevention of PHS after PD by analyzing prospectively collected data.
Methods : Among patients who were assigned randomly to receive HPERT (40,000 IU of Norzyme® for 3 months or placebo in the previous prospective study (Clin Gastroenterol Hepatol. 2020;18:926–934), 94 patients who had unenhanced computer tomography (CT) scans at preoperative and postoperative 1 year were enrolled in this study. PHS was defined when mean CT values of the liver were < 40 Housnfield unit (HU) or 10HU lower than values of the spleen. The incidence and risk factors of newly developed PHS at postoperative 1 year were analyzed.
Results : There were 42 patients in the HPERT group and 52 patients in the placebo group. The incidence of PHS was significantly lower in the HPERT group (4/42) compared with the placebo group(12/52) (P<0.001). Multivariate analysis identified placebo intake (odds ratio[OR]1.640,p=0.020), preoperative BMI>24(OR 9.065, P=0.032), body weight loss>5% in postoperative 3 months (OR 2.087, P=0.024) as independent risk factors. Subgroup analysis showed that the lower incidence of PHS after HPERT compared with the placebo control were consistent in high risk groups: preoperative BMI>24 (HPERT vs. placebo, 3/14 vs.13/22, P=0.019) and body weight loss>5% ( 4/12 vs. 30/46 p=0.013).
Conclusions : The results revealed that HPERT significantly reduced the development of PHS after PD.
Methods : Among patients who were assigned randomly to receive HPERT (40,000 IU of Norzyme® for 3 months or placebo in the previous prospective study (Clin Gastroenterol Hepatol. 2020;18:926–934), 94 patients who had unenhanced computer tomography (CT) scans at preoperative and postoperative 1 year were enrolled in this study. PHS was defined when mean CT values of the liver were < 40 Housnfield unit (HU) or 10HU lower than values of the spleen. The incidence and risk factors of newly developed PHS at postoperative 1 year were analyzed.
Results : There were 42 patients in the HPERT group and 52 patients in the placebo group. The incidence of PHS was significantly lower in the HPERT group (4/42) compared with the placebo group(12/52) (P<0.001). Multivariate analysis identified placebo intake (odds ratio[OR]1.640,p=0.020), preoperative BMI>24(OR 9.065, P=0.032), body weight loss>5% in postoperative 3 months (OR 2.087, P=0.024) as independent risk factors. Subgroup analysis showed that the lower incidence of PHS after HPERT compared with the placebo control were consistent in high risk groups: preoperative BMI>24 (HPERT vs. placebo, 3/14 vs.13/22, P=0.019) and body weight loss>5% ( 4/12 vs. 30/46 p=0.013).
Conclusions : The results revealed that HPERT significantly reduced the development of PHS after PD.
SESSION
Plenary Session
Room A 3/27/2021 11:30 AM - 11:45 AM