Ann Surg Treat Res.
2024 Oct;107(4):203-211. 10.4174/astr.2024.107.4.203.
The effects of sarcopenic obesity on immediate postoperative outcomes after pancreatoduodenectomy: a retrospective cohort study
- Affiliations
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- 1Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, Korea
- 2Division of Hepatobiliary, Pancreas, and Abdominal Organ Transplant, Department of Surgery, The Catholic University of Korea Incheon St. Mary’s Hospital, Incheon, Korea
- 3Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
- 4Department of Gastrointestinal Surgery, Yonsei University College of Medicine, Seoul, Korea
- KMID: 2560005
- DOI: http://doi.org/10.4174/astr.2024.107.4.203
Abstract
- Purpose
Several studies have evaluated the impact of sarcopenic obesity (SO) on postoperative complications, including postoperative pancreatic fistula (POPF), in patients undergoing pancreatoduodenectomy (PD). Previous studies have shown that SO increases POPF, but it remains unclear whether SO increases postoperative complications. In this study, we aimed to determine the relationship between SO and immediate postoperative complications.
Methods
From January 2005 to December 2019, the medical records of patients who underwent PD for periampullary cancer were retrospectively reviewed. Skeletal muscle index (SMI) and visceral fat area (VFA) were calculated from preoperative computed tomography images. Patients with high VFA were classified as obese, while those with low SMI were classified as sarcopenic. Patients were divided into 4 groups: normal group, sarcopenia only group, obesity only group, and SO group. Postoperative outcomes were compared between groups, and factors affecting postoperative complications were analyzed by multivariate analysis.
Results
Normal group (n = 176), sarcopenia only group (n = 130), obesity only group (n = 207), and SO group (n = 117) were analyzed retrospectively. SO group had significantly more frequent major complications compared to the normal group (P = 0.006), as well as a significantly more frequent clinically relevant POPF compared to the other groups (P = 0.002). In multivariate analysis, SO was an independent risk factor for major complications (P = 0.008) and clinically relevant POPF (P = 0.003).
Conclusion
SO is a factor associated with poor immediate postoperative outcomes after PD for periampullary cancer.
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