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Abdominal aortic calcification volume (AACV) is a predictive factor for postoperative complications associated with biliary tract cancer

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Abstract

Purpose

Curative surgical treatment of biliary tract cancer is highly invasive and involves postoperative complications. Abdominal aortic calcification is a parameter that is reportedly linked to systemic arteriosclerosis. We measured the abdominal aortic calcification volume (AACV), assessed the correlation between AACV and postoperative complications, and evaluated the clinical utility of AACV.

Methods

We retrospectively evaluated 97 patients (ampullary carcinoma, n = 21; distal bile duct cancer, n = 43; hilar bile duct cancer, n = 33). We assessed the calcification volume of the abdominal aorta from the renal artery ramification to the common iliac artery bifurcation. The correlation between AACV, clinical factors, and postoperative complications was evaluated.

Results

The average AACV was 5.02 cm3, and the median AACV was 3.74 (range 0–27.4) cm3. The AACV was significantly related to age (P = 0.009), Brinkman index (P = 0.007), and history of cardiovascular disease (P = 0.015). The AACV was strongly correlated with postoperative complications (P < 0.001) and Clavien–Dindo grade > III postoperative complications (P < 0.001). The AACV was also correlated with pancreatic fistula in pancreatectomy cases (P < 0.001). A multivariate analysis revealed that the AACV was an independent predictor of postoperative complications.

Conclusion

The AACV was significantly associated with postoperative complications. The AACV could be used for the preoperative assessment of surgical risk.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Mr. Junya Fukuda for his excellent assistance.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Akira Watanabe, Norifumi Harimoto, Kenichiro Araki, Mariko Tsukagoshi, Norihiro Ishii, Kei Hagiwara, Takahiro Yamanaka, Kouki Hoshino, Ryo Muranushi & Ken Shirabe

  2. Department of Innovative Cancer Immunotherapy, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Mariko Tsukagoshi

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  1. Akira Watanabe
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Correspondence to Norifumi Harimoto.

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This study was approved by the Institutional Ethics Committee of Gunma University (Approval No. HS 2021-119).

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Watanabe, A., Harimoto, N., Araki, K. et al. Abdominal aortic calcification volume (AACV) is a predictive factor for postoperative complications associated with biliary tract cancer. Surg Today 53, 207–213 (2023). https://doi.org/10.1007/s00595-022-02621-5

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  • DOI: https://doi.org/10.1007/s00595-022-02621-5

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