Body Mass Index and Outcomes from Pancreatic Resection: a Review and Meta-analysis

Review Article

Abstract

Introduction

There are 1.6 billion adults worldwide who are overweight, with body mass indices (BMI) between 25 and 30, while more than 400 million are obese (BMI >30). Obesity predicts the incidence of and poor outcomes from pancreatic cancer. Obesity has also been linked to surgical complications in pancreatectomy, including increased length of hospital stay, surgical infections, blood loss, and decreased survival. However, BMI’s impact on many complications following pancreatectomy remains controversial.

Methods

We performed a MEDLINE search of all combinations of “BMI” with “pancreatectomy,” “pancreatoduodenectomy,” or “pancreaticoduodenectomy.” From included studies, we created pooled and weighted estimates for quantitative and qualitative outcomes. We used the PRISMA criteria to ensure this project’s validity.

Results

Our primary cohort included 2,736 patients with BMI <30, 1,682 with BMI >25, and 546 with BMI between 25 and 30. Most outcomes showed no definitive differences across BMIs. Pancreatic fistula (PF) rates ranged from 4.7% to 31.0%, and four studies found multivariate association between BMI and PF (range odds ratio 1.6–4.2). Pooled analyses of PF by BMI showed significant association (p < 0.05).

Conclusion

BMI increases the operative complexity of pancreatectomy. However, with aggressive peri- and post-operative care, increases in BMI-associated morbidity and mortality may be mitigated.

Keywords

Pancreatic neoplasms Obesity Morbidity Outcomes 

Notes

Competing Interests

We declare that we have no competing interests.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  1. 1.Division of Surgical Oncology, Department of SurgeryUniversity of Louisville School MedicineLouisvilleUSA

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