Japan Digestive Disease Week 2025
International Poster Session16 (JDDW)
October 31, 15:44–16:16, Room 15 (Kobe International Exhibition Hall No.1 Building Digital Poster Venue)
IP-80_S
Biomarker-Driven Precision Medicine for de novo Liver Steatosis After Pancreatoduodenectomy
- 1
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine
Background Postoperative exocrine pancreatic insufficiency and steatotic liver disease (SLD) occur in approximately 30% of patients undergoing pancreaticoduodenectomy (PD). However, the mechanism underlying SLD development after pancreatectomy remains unclear.
Methods We analyzed preoperative and three-month postoperative blood samples from 114 PD patients. SLD was defined as a liver-to-spleen attenuation ratio of ≤0.9 on non-contrast CT.
Results The cohort comprised 48% female patients with a median age of 71 years. Among patients without preoperative SLD (n=106), 32% developed SLD postoperatively. Female sex was independently associated with the development of postoperative SLD. Essential fatty acid concentrations were significantly decreased postoperatively, among which docosapentaenoic acid (DPA) levels showed the strongest association with postoperative SLD. Unlike patients with metabolic dysfunction-associated SLD (MASLD), patients who developed postoperative SLD exhibited reduced cholesterol levels. Triglyceride levels were also reduced in most lipoprotein fractions, except for LDL. The triglyceride-to-cholesterol ratio was calculated, revealing a unique elevation in the LDL fractions among patients with postoperative SLD- a pattern not observed in MASLD patients.
Conclusions Postoperative SLD development was associated with female sex and postoperative DPA concentrations. Patients with postoperative SLD exhibited a distinctive triglyceride-to-cholesterol ratio pattern in LDL fractions, which differed from the metabolic profile observed in MASLD patients.
Methods We analyzed preoperative and three-month postoperative blood samples from 114 PD patients. SLD was defined as a liver-to-spleen attenuation ratio of ≤0.9 on non-contrast CT.
Results The cohort comprised 48% female patients with a median age of 71 years. Among patients without preoperative SLD (n=106), 32% developed SLD postoperatively. Female sex was independently associated with the development of postoperative SLD. Essential fatty acid concentrations were significantly decreased postoperatively, among which docosapentaenoic acid (DPA) levels showed the strongest association with postoperative SLD. Unlike patients with metabolic dysfunction-associated SLD (MASLD), patients who developed postoperative SLD exhibited reduced cholesterol levels. Triglyceride levels were also reduced in most lipoprotein fractions, except for LDL. The triglyceride-to-cholesterol ratio was calculated, revealing a unique elevation in the LDL fractions among patients with postoperative SLD- a pattern not observed in MASLD patients.
Conclusions Postoperative SLD development was associated with female sex and postoperative DPA concentrations. Patients with postoperative SLD exhibited a distinctive triglyceride-to-cholesterol ratio pattern in LDL fractions, which differed from the metabolic profile observed in MASLD patients.
- Index Term 1: pancreatectomy
- Index Term 2: complication