The relation between obesity and severe postoperative complications after pancreaticoduodenectomy.

Zanden, R.J.C. van der (2014) The relation between obesity and severe postoperative complications after pancreaticoduodenectomy. thesis, Medicine.

Text ZandenvanderRJC.pdf Restricted to Registered users only Download (1MB)

Abstract

Background: Pancreaticoduodenectomy (PD) is the only potentially curative treatment in patients with pancreatic cancer. PD remains a riskful procedure with postoperative complication rates about 40% in general and 20% for severe complications. Obesity is considered a major risk factor for postoperative complications in pancreatic surgery. But the literature is not univocal about which obesity measure, body mass index (BMI) or visceral fat, is the best predictor of obesity. Hence, this study examined the relation between various obesity measures and severe postoperative complications after PD. The secondary aim was to investigate survival time with BMI and with postoperative complications. Methods: This retrospective cohort research reviewed 77 patients who underwent a PD between January 2012 and November 2013. Demographic -, clinical - and operative variables, 30-day morbidity, 30-day and 90-day mortality were collected in standardized fashion. Patients were classified in two groups by severe and non-severe complications. All postoperative complications with a Clavien-Dindo classification of IIIa or higher were considered as severe complications. Univariate and multivariate logistic regression analysis were performed. Survival was displayed by Kaplan-Meier curves and analyzed by Cox regression. Results: BMI was borderline significantly (p=0.05) associated with severe postoperative complications. Postoperative complications occurred in 72.7% of the patients, of which 26.0% had a severe complication. The 30-day and 90-day mortality were 2.6 and 4.4%. Survival analysis showed a significant difference (p=0.018) in survival time between patients with severe and non-severe complications. Survival time showed no differences between patients with no and ≥ one complications and also not between patients with a normal weight and overweight/obesity. Conclusions: BMI is better related to severe postoperative complications than other obesity measures. Furthermore, survival time showed no difference between patients with a normal weight and patients with overweight/obesity.

Item Type:	Thesis (Thesis)
Supervisor name:	Klaase, Dr. J.M. and Medical Spectrum Twente, Enschede
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:40
Last Modified:	25 Jun 2020 10:40
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/141

Actions (login required)

View Item