Sargun Virk, Sangrag Ganguli, Ye In Christopher Kwon, Saba Alvi, Muhammad Wasif Saif, and Hassan Aziz*
Background There is literature showing an association between obesity and outcomes of pancreatic surgery. Obesity is mainly calculated by the use of the Body Mass Index. There are inherent flaws in using a simple BMI that takes into account only two variables. Our study aims to highlight the use of a Body Fat percentage calculator to predict obesity and its subsequent implications in outcomes after pancreaticoduodenectomy (PD). Methods A retrospective analysis of the 2019 NSQIP database was performed. First, patients were categorized into obese and Non-obese groups based on BF percentage. Then, we matched the two groups based on propensity score matching in a 1:1 ratio. The primary outcome measure was mortality. Secondary outcome measures were complications, including pancreatic fistula. Results After propensity score matching in a 1:1 ratio, there were 670 patients in the obese group and 670 in the nonobese group. Obese patients were more likely to have superficial surgical site infections (7% vs. 4.4%; p-0.04), and pulmonary embolism (3.4% vs. 0.2%; p-0.02), organ space surgical site infection (20.1% vs. 13.9%; p-0.002); rates of biochemical leaks (9.5% vs. 5%; p-0.001) and Grade B/C POPF (16.2% vs. 10.4%; p-0.001). There was no difference in mortality between the two groups (2.1% vs. 1.1%; p-0.1). Conclusion Percent body fat may help surgeons improve risk stratifications, project patient-reported functional outcomes, and better educate obese patients regarding postoperative expectations before undergoing pancreatic resections.
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