Risk factors for hepatic steatosis after pancreatectomy: a retrospective observational cohort study of the importance of nutritional management

The occurrence of hepatic steatosis after pancreatectomy has been previously known. However, this condition has been neglected because its clinical course has been considered benign. The aims of this study were to identify the risk factors for hepatic steatosis after pancreatectomy, to clarify the impact of this condition on long-term prognosis, and to suggest methods for preventing hepatic steatosis. One hundred two patients, who were diagnosed with postoperative computed tomography, were enrolled. The severity of hepatic steatosis was determined by using unenhanced computed tomography. The variables that might influence the development of hepatic steatosis were compared between the groups with and without hepatic steatosis. The incidence of postoperative hepatic steatosis was 31.4%. Multivariate analysis showed that absence of postoperative insulin use (P < 0.01) and decrease in postoperative body mass index of greater than 3 kg/m(2) (P < 0.01) were independent risk factors for hepatic steatosis. The cumulative recurrence-free survival rate of the group with hepatic steatosis was poorer than that of the group without (P = 0.053). Postoperative hepatic steatosis may affect long-term prognosis after pancreatectomy. Surgeons should take care of nutritional management including insulin therapy for patients with hepatic steatosis after pancreatectomy.