{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T05:31:45Z","timestamp":1791955905208,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to compare the incidence of postoperative nonalcoholic fatty liver disease (NAFLD), postoperative cholangitis, and fibrosis\u20104 (FIB)\u20104 index in patients who underwent duodenum\u2010preserving pancreatic head resection (DPPHR) and pancreaticoduodenectomy (PD) for low\u2010grade malignant tumors and verify the usefulness of DPPHR in preventing the occurrence of these disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 70 patients who underwent PD (n\u00a0=\u00a039) and DPPHR (n\u00a0=\u00a031) between 2006 and 2018 for benign or low\u2010grade malignant tumors. The present study compared the preoperative background, cumulative incidence of postoperative NAFLD and cholangitis, and other biochemical markers, including the FIB\u20104 index. Subanalysis by propensity score matching (PSM) analysis was conducted to minimize treatment selection bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In terms of the cumulative incidence of NAFLD, the 5\u2010y incidence was significantly lower in the DPPHR group than in the PD group both before (10% vs 38%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002) and after (13% vs 38%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.008) matching. Multivariate analyses identified DPPHR as the only independent preventive factor for postoperative NAFLD (hazard ratio: 0.160, 95% confidence intervals: 0.034\u20130.76, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.021). The 5\u2010y cumulative incidence of postoperative cholangitis was significantly higher in the PD group than in the DPPHR group before (51% vs 3%, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and after (49% vs 4%, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) matching. The FIB\u20104 index at 12\u2009mo postoperatively was significantly better in the DPPHR group than in the PD group (1.45 vs 2.35, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.006) before matching.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preservation of the duodenum and bile duct may contribute to preventing long\u2010term postoperative NAFLD and cholangitis, and liver fibrosis for benign or low\u2010grade malignant pancreatic head tumors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ags3.12593","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T10:51:07Z","timestamp":1656586267000},"page":"851-861","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Significant positive impact of duodenum\u2010preserving pancreatic head resection on the prevention of postoperative nonalcoholic fatty liver disease and acute 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