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Correlation between the skeletal muscle index and surgical outcomes of pancreaticoduodenectomy

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Abstract

Purposes

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.

Materials

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.

Results

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.

Conclusion

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.

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Funding

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

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi-City, Kochi, 781-8555, Japan

    Kenta Sui, Takehiro Okabayshi & Tatsuaki Sumiyoshi

  2. Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi-City, Japan

    Jun Iwata

  3. Department of Radiology, Kochi Health Sciences Center, Kochi-City, Japan

    Sojiro Morita

  4. Department of Biostatistics, Kochi Medical School, Kochi, Japan

    Tatsuo Iiyama

  5. Department of Clinical Oncology, Kochi Health Sciences Center, Kochi-City, Japan

    Yasuhiro Shimada

Authors
  1. Kenta Sui
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  2. Takehiro Okabayshi
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  3. Jun Iwata
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  4. Sojiro Morita
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  5. Tatsuaki Sumiyoshi
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  6. Tatsuo Iiyama
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  7. Yasuhiro Shimada
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Corresponding author

Correspondence to Takehiro Okabayshi.

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Conflict of interest

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

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Sui, K., Okabayshi, T., Iwata, J. et al. Correlation between the skeletal muscle index and surgical outcomes of pancreaticoduodenectomy. Surg Today 48, 545–551 (2018). https://doi.org/10.1007/s00595-017-1622-7

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  • DOI: https://doi.org/10.1007/s00595-017-1622-7

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