Obese patients are at higher risk for pancreatic surgery complications

Obesity may contribute to a greater likelihood of post-operative complications for patients having pancreatic surgery, a surgeon at Thomas Jefferson University Hospital has found.

A study of 202 pancreatic surgeries from 2000 to 2005 indicates obese patients had an increased time on the operating table, blood loss, length of hospital stay and rate of serious complications compared to normal weight individuals, said Adam Berger, M.D., assistant professor of surgery at Jefferson Medical College of Thomas Jefferson University

“A rise in a patient's Body Mass Index (BMI) is one of the most important health issues facing health care professionals today,” Dr. Berger noted. “Higher BMI can lead to a greater risk of a patient developing diabetes and heart disease, as well as esophageal and pancreatic cancers.

“Increased BMI has been demonstrated to be an important factor predicting perioperative morbidity and mortality in patients undergoing numerous operations,” Dr. Berger added.

At the time of surgeries, 85 (46 percent) patients were normal weight, 54 (29 percent) were overweight and 45 (25 percent) were obese, the study indicates. There were four perioperative patient deaths (2 percent), two of which were in the normal weight group and two in the obese group.

In addition, obese patients had an increased rate of serious complications compared to normal and overweight patients (27 percent vs. 18 percent and 15 percent, respectively).

Nearly half the patients underwent a classic Whipple procedure, in which the gallbladder, common bile duct, lower part of the stomach, all of the duodenum (the first part of the small intestine) and the head of the pancreas are removed. Others underwent a pylorus-preserving pancreaticoduodenectomy, in which the head of the pancreas is removed.

“Obese patients are at higher risk for perioperative complications, however, this should not preclude them from having pancreatic surgery,” Dr. Berger noted.

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