Surgery Today

, Volume 48, Issue 5, pp 545–551 | Cite as

Correlation between the skeletal muscle index and surgical outcomes of pancreaticoduodenectomy

  • Kenta Sui
  • Takehiro Okabayshi
  • Jun Iwata
  • Sojiro Morita
  • Tatsuaki Sumiyoshi
  • Tatsuo Iiyama
  • Yasuhiro Shimada
Original Article



Sarcopenia is known to be associated with a worse prognosis following abdominal operations; however, the relationship between sarcopenia and the outcomes of pancreaticoduodenectomy remains unclear.


We measured body composition parameters, including total abdominal muscle area, using preoperative staging computed tomography (CT), in patients undergoing pancreaticoduodenectomy for periampullary cancer. The incidence of sarcopenia among these patients was evaluated and multivariable analysis was performed to identify independent predictors of postoperative pancreatic fistula.


We identified 335 consecutive patients who were eligible for the study. Patients with sarcopenia had significantly poorer 5-year survival rates than those without sarcopenia (32.4 vs. 51.6%, respectively, P = 0.009). Interestingly, the incidence of Grade B/C pancreatic fistula was significantly lower in the sarcopenia group than in the non-sarcopenia group. Multivariate analysis identified high body mass index and soft pancreatic texture as independent predictors of postoperative pancreatic fistula.


Sarcopenia may have an independent prognostic effect on the survival of patients with periampullary cancer. Preoperative nutritional intervention and rehabilitation may improve the postoperative outcomes of pancreaticoduodenectomy for periampullary cancer.


Pancreaticoduodenectomy Periampullary adenocarcinoma Surgery Sarcopenia Outcomes 



This work was supported by the Kochi Organization for Medical Reformation and Renewal grants.

Compliance with ethical standards

Conflict of interest

Kenta Sui and his co-authors have no conflicts of interest to declare.


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Copyright information

© Springer Japan KK, part of Springer Nature 2017

Authors and Affiliations

  • Kenta Sui
    • 1
  • Takehiro Okabayshi
    • 1
  • Jun Iwata
    • 2
  • Sojiro Morita
    • 3
  • Tatsuaki Sumiyoshi
    • 1
  • Tatsuo Iiyama
    • 4
  • Yasuhiro Shimada
    • 5
  1. 1.Department of Gastroenterological SurgeryKochi Health Sciences CenterKochi-CityJapan
  2. 2.Department of Diagnostic PathologyKochi Health Sciences CenterKochi-CityJapan
  3. 3.Department of RadiologyKochi Health Sciences CenterKochi-CityJapan
  4. 4.Department of BiostatisticsKochi Medical SchoolKochiJapan
  5. 5.Department of Clinical OncologyKochi Health Sciences CenterKochi-CityJapan

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