Obesity as a risk factor for the pancreatic fistula after pancreaticoduodenectomy

Introduction: Performing pancreaticoduodenectomy (PD) to obese patients is more challenging and hazardous. Among the complications after PD, postoperative pancreatic fistula (POPF) is a persistent and life threatening problem. In this study, we investigated the specific impact of obesity on POPF after PD. Materials & Methods: A retrospective analysis was conducted on 58 consecutive patients undergoing PD, with measurable fat volume, from July 2007 to March 2010. Volumetric measurement of abdominal visceral and subcutaneous fat tissue was performed by computed tomography. Intraoperative and perioperative data were collected, and the relationship between surgical outcome and obesity was investigated. Results: Among 58 patients, 14 patients developed POPF (24%). Concerning obesity, subcutaneous fat area, visceral fat area, body weight and BMI were significantly higher in the patients with POPF than those in the patients without POPF. In the patients with POPF, operation time is longer than in the patients without POPF, but the difference was not significant. Intraoperative blood loss, and intraoperative blood transfusion is larger in the patients with POPF, but the difference was not significant. Conclusion: Patients with POPF were more obese, and therefore, obesity may be a risk factor for POPF after PD.