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

• Jeong JH
• Kim JS
• Kim Ss
• Hong SS
• Hwang HK
• Kang CM
• Kim HI
• Kim KS
• Kim SH

• 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.

Keyword

Body composition; Obesity; Pancreatoduodenectomy; Postoperative complications; Sarcopenia

Figure

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  Fig. 1 Study flow diagram. SMI, skeletal muscle index (skeletal muscle area/height); VFA, visceral fat area.

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