The impact of body mass index on pancreatic fistula after pancreaticoduodenectomy in Asian patients on the basis of Asia-Pacific perspective of body mass index.

CONTEXT Several surgical complications are related to obesity. OBJECTIVE This study evaluated the impact of obesity on pancreatic fistula after pancreaticoduodenectomy. DESIGN We retrospectively reviewed the medical records of 159 patients who underwent pancreaticoduodenectomy between October 2002 and December 2008. SETTING The patients were divided according to the body mass index as obese (body mass index equal to, or greater than, 25 kg/m(2)), or normal (body mass index less than 25 kg/m(2)). METHODS Univariate and multivariate analyses were applied. Two-tailed P values less than 0.05 were considered as significant. RESULTS Forty-six patients (28.9%) were obese and 113 patients (71.1%) were normal-weight. Obese group had a significantly higher incidence of pancreatic fistula and a greater amount of intraoperative blood loss. Other surgical complications were not significantly different between the two groups. Multivariate analysis found obesity, small pancreatic duct size (less than, or equal to, 3 mm), intraoperative blood loss, and combined resection as significant factors affecting pancreatic fistula. CONCLUSIONS Obese patients have an increased risk for pancreatic fistula after pancreaticoduodenectomy.