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Preoperative Sarcopenia Strongly Influences the Risk of Postoperative Pancreatic Fistula Formation After Pancreaticoduodenectomy

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Postoperative pancreatic fistula (POPF) is a serious complication of pancreaticoduodenectomy (PD). Sarcopenia is a newly identified marker of frailty. We performed this study to assess whether preoperative sarcopenia has an impact on clinically relevant POPF formation.

Methods

A total of 266 consecutive patients who underwent a PD between 2010 and 2014 were enrolled in this retrospective study. Skeletal muscle mass was measured using preoperative computed tomography images. The impact of preoperative sarcopenia on clinically relevant POPF formation was analyzed using univariate and multivariate analyses.

Results

Of the 266 patients, 132 (49.6 %) were classified as having preoperative sarcopenia. The rate of clinically relevant POPF formation was significantly higher in the sarcopenia group (22.0 vs. 10.4 %; P = 0.011). A multivariate logistic regression analysis showed that sarcopenia (odds ratio, 2.869; P = 0.007) was an independent risk factor for the development of clinically relevant POPF, along with a soft pancreas and a parenchymal thickness at the pancreatic resection site of ≥8 mm.

Conclusions

Preoperative sarcopenia was identified as a strong and independent risk factor for clinically relevant POPF formation after PD. Perioperative rehabilitation and nutrition therapy may contribute to the prevention of POPF formation and a safer PD.

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Authors and Affiliations

  1. Department of Hepatobiliary-Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Yasunori Nishida, Yuichiro Kato, Masashi Kudo, Hidetoshi Aizawa, Satoshi Okubo, Daigoro Takahashi, Yusuke Nakayama, Kazuhiko Kitaguchi, Naoto Gotohda, Shinichiro Takahashi & Masaru Konishi

Authors
  1. Yasunori Nishida
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  2. Yuichiro Kato
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  3. Masashi Kudo
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  4. Hidetoshi Aizawa
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  5. Satoshi Okubo
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  6. Daigoro Takahashi
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  7. Yusuke Nakayama
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  8. Kazuhiko Kitaguchi
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  11. Masaru Konishi
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Correspondence to Yuichiro Kato.

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The study protocol was approved by the Institutional Review Board of the National Cancer Center, Japan.

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The authors declare that they have no conflicts of interest.

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Nishida, Y., Kato, Y., Kudo, M. et al. Preoperative Sarcopenia Strongly Influences the Risk of Postoperative Pancreatic Fistula Formation After Pancreaticoduodenectomy. J Gastrointest Surg 20, 1586–1594 (2016). https://doi.org/10.1007/s11605-016-3146-7

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  • DOI: https://doi.org/10.1007/s11605-016-3146-7

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