Preresection Obesity Increases the Risk of Hepatobiliary Complications in Short Bowel Syndrome 英文参考文献.docVIP

Nutrients 2012, 4, 1358-1366; doi:10.3390/nu4101358 OPEN ACCESS nutrients ISSN 2072-6643 /journal/nutrients Article Preresection Obesity Increases the Risk of Hepatobiliary Complications in Short Bowel Syndrome Jon S. Thompson 1,*, Rebecca A. Weseman 1, Fedja A. Rochling 1, Wendy J. Grant 1, Jean F. Botha 2, Alan N. Langnas 1 and David F. Mercer 1 1 The University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE 68198, USA; E-Mails: Rebecca.weseman@ (R.A.W.); frochling@ (F.A.R.); wgrant@ (W.J.G.); alangnas@ (A.N.L.); dmercer@ (D.F.M.) 2 University of the Witwatersrand, Johannesburg, 1 Jan Smuts Avenue, Braamfontein 2000, Johannesburg, South Africa; E-Mail: Jeanf.botha@ * Author to whom correspondence should be addressed; E-Mail: jthompso@; Tel.: +1-402-559-7182; Fax: +1-402-559-6749. Received: 28 June 2012; in revised form: 11 September 2012 / Accepted: 18 September 2012 / Published: 26 September 2012 Abstract: Patients developing the short bowel syndrome (SBS) are at risk for hepatobiliary disease, as are morbidly obese individuals. We hypothesized that morbidly obese SBS individuals would be at increased risk for developing hepatobiliary complications. We reviewed 79 patients with SBS, 53 patients with initial body mass index (BMI) 35 were controls. Twenty-six patients with initial BMI 35 were the obese group. Obese patients were more likely to be weaned off parenteral nutrition (PN) (58% vs. 21%). Pre-resection BMI was significantly lower in controls (26 vs. 41). BMI at 1, 2, and 5 years was decreased in controls but persistently increased in obese patients. Obese patients were more likely to undergo cholecystectomy prior to SBS (42% vs. 32%) and after SBS (80% vs. 39%, p 0.05). Fatty liver was more frequent in the obese group prior to SBS (23% vs. 0%, p 0.05) but was similar to controls after SBS (23% vs. 15%). Fibrosis (8% vs. 13%) and cirrhosis/portal hypertension (19% vs.