Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy.

Autor:	Zarzavadjian Le Bian A; Alban Zarzavadjian Le Bian, Manuela Cesaretti, Renato Costi, Department of Digestive Surgery, Centre Hospitalier Simone Veil, 95600 Eaubonne, France., Fuks D; Alban Zarzavadjian Le Bian, Manuela Cesaretti, Renato Costi, Department of Digestive Surgery, Centre Hospitalier Simone Veil, 95600 Eaubonne, France., Chopinet S; Alban Zarzavadjian Le Bian, Manuela Cesaretti, Renato Costi, Department of Digestive Surgery, Centre Hospitalier Simone Veil, 95600 Eaubonne, France., Gaujoux S; Alban Zarzavadjian Le Bian, Manuela Cesaretti, Renato Costi, Department of Digestive Surgery, Centre Hospitalier Simone Veil, 95600 Eaubonne, France., Cesaretti M; Alban Zarzavadjian Le Bian, Manuela Cesaretti, Renato Costi, Department of Digestive Surgery, Centre Hospitalier Simone Veil, 95600 Eaubonne, France., Costi R; Alban Zarzavadjian Le Bian, Manuela Cesaretti, Renato Costi, Department of Digestive Surgery, Centre Hospitalier Simone Veil, 95600 Eaubonne, France., Belgaumkar AP; Alban Zarzavadjian Le Bian, Manuela Cesaretti, Renato Costi, Department of Digestive Surgery, Centre Hospitalier Simone Veil, 95600 Eaubonne, France., Smadja C; Alban Zarzavadjian Le Bian, Manuela Cesaretti, Renato Costi, Department of Digestive Surgery, Centre Hospitalier Simone Veil, 95600 Eaubonne, France., Gayet B; Alban Zarzavadjian Le Bian, Manuela Cesaretti, Renato Costi, Department of Digestive Surgery, Centre Hospitalier Simone Veil, 95600 Eaubonne, France.
Jazyk:	angličtina
Zdroj:	World journal of gastroenterology [World J Gastroenterol] 2017 May 07; Vol. 23 (17), pp. 3142-3149.
DOI:	10.3748/wjg.v23.i17.3142
Abstrakt:	Aim: To analyze immediate postoperative outcomes after pancreaticoduodenectomy regarding metabolic syndrome. Methods: In two academic centers, postoperative outcomes of patients undergoing pancreaticoduodenectomy from 2002 to 2014 were prospectively recorded. Patients presenting with metabolic syndrome [defined as at least three criteria among overweight (BMI ≥ 28 kg/m²), diabetes mellitus, arterial hypertension and dyslipidemia] were compared to patients without metabolic syndrome. Results: Among 270 consecutive patients, 29 (11%) presented with metabolic syndrome. In univariable analysis, patients with metabolic syndrome were significantly older (69.4 years vs 62.5 years, P = 0.003) and presented more frequently with soft pancreas (72% vs 22%, P = 0.0001). In-hospital morbidity (83% vs 71%) and mortality (7% vs 6%) did not differ in the two groups so as pancreatic fistula rate (45% vs 30%, P = 0.079) and severity of pancreatic fistula ( P = 0.257). In multivariable analysis, soft pancreas texture ( P = 0.001), pancreatic duct diameter < 3 mm ( P = 0.025) and BMI > 30 kg/m² ( P = 0.041) were identified as independent risk factors of pancreatic fistula after pancreaticoduodenectomy, but not metabolic syndrome. Conclusion: In spite of logical reasoning and appropriate methodology, present series suggests that metabolic syndrome does not jeopardize postoperative outcomes after pancreaticoduodenectomy. Therefore, definition of metabolic syndrome seems to be inappropriate and fatty pancreas needs to be assessed with an international consensual histopathological classification. Competing Interests: Conflict-of-interest statement: All authors have no conflict of interest.
Databáze:	MEDLINE
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