The impact of pylorus preservation on the development of nonalcoholic fatty liver disease after pancreaticoduodenectomy: A historical cohort study.

BACKGROUND/PURPOSE: The pathophysiology and associated factors of nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD) remain elusive. We aimed to investigate these factors, including the operation type, for NAFLD development after PD. METHODS: This historical cohort study included 786 consecutive patients treated with either classic Whipple operation or pylorus-preserving pancreaticoduodenectomy (PPPD) in Korea between 2012 and 2018. De novo NAFLD was determined based on hepatic attenuation in nonenhanced computed tomography during follow-up. RESULTS: Of the 786 patients, 216 (27.5%) had a newly developed NAFLD at 2 years after PD. The incidences of newly developed NAFLD at 0.5, 1, 1.5, and 2 years were 13 (1.7%), 41 (5.2%), 48 (6.1%), and 114 (14.5%), respectively. The Whipple group showed a significantly higher incidence of NAFLD than the PPPD group (40.3% vs 24.5%, P < .001). Seventeen patients (2.2%) had severe fatty liver with abnormal liver enzymes. Multivariable analysis revealed that Whipple operation (vs PPPD; adjusted odds ratio [AOR]: 1.92, P < .001) and high preoperative body mass index (vs normal; AOR: 1.71, P = .001) were independently associated with a higher risk of NAFLD. CONCLUSION: The incidence of NAFLD was 27.5% at 2 years after PD. Undergoing Whipple operation and high preoperative body mass index were significantly associated with de novo NAFLD development.

Antihyperglycemic effects of fruits of privet (Ligustrum obtusifolium) in streptozotocin-induced diabetic rats fed a high fat diet.

The protective effects of freeze-dried privet (Ligustrum obtusifolium) fruits (PFs) were observed in streptozotocin (STZ)-induced diabetic rats on a high fat diet by measuring levels of blood glucose, serum insulin, fructosamine, and hepatic reactive oxygen species generating and scavenging enzyme activities. A PF-supplemented diet was prepared by mixing an AIN-76 diet with powdered PF (final concentration, 1% or 2%). It was fed to STZ-induced diabetic rats on a high fat diet for 6 weeks. Diabetic animals receiving the PF-supplemented diet showed a significant increase in body weight, feed efficiency ratio, liver, kidney, and heart weight, and serum glucose, insulin, and fructosamine levels compared with high fat diet-fed diabetic animals. The treatment with PF showed improved hepatic glutathione S-transferase, superoxide dismutase, and xanthine oxidase activities as well as glutathione and lipid peroxide levels in the diabetic animals. Intracellular swelling and vacuole formation in diabetic pancreatic beta- and delta-cells were ameliorated by the PF-supplemented diet. Furthermore, necrosis of tubular epithelial cells and dilatation of luminal space in diabetic kidneys exhibited near-noninjured condition. This is the first time an antihyperglycemic effect of L. obtusifolium fruit in STZ-induced diabetic rats has been identified.