Detailed Abstract
[Poster - Pancreas Disease/Surgery]
[P106] Sarcopenic obesity is a risk factor for postoperative pancreatic fistula after pancreatoduodenectomy
MinJi JANG2, Hyung Woo PARK1, Jong Hwa LEE2, Yoong Ki JEONG2, Yang Won NAH1, Jimi HUH2
1Department of Surgery, Ulsan University Hospital, Korea
2Department of Radiology, Ulsan University Hospital, Korea, Korea
Introduction : The relationship between body composition and outcomes following pancreatoduodenectomy (PD) is still unclear. The aim of this study was to assess the impact of sarcopenia and visceral obesity on outcomes in patients undergoing PD.
Methods : Body composition parameters including total abdominal muscle area and visceral fat area were assessed by preoperative CT in patients who underwent PD from 2005 to 2016 (Fig 1). Based on preoperative CT/MRIs, we evaluated the presence of main pancreatic duct (MPD) dilatation and pancreatic fatty degeneration as well. Perioperative variables and postoperative outcomes were collected from the medical records. The POPF were scored according to the ISGPF definition. The severe complications were defined as Clavien-Dindo class III and IV. Univariate and multivariate logistic regression analyses were performed.
Results : A total of 284 patients (163 male, 121 female) met the inclusion criteria. The POPF (grade II + III) rate was 18.3% (52/284) and severe complication rate was 12.0% (34/284). Mortality rate was 2.1% (6). In both univariate and multivariate analyses, the sarcopenic obesity was the only independent predictor for POPF (OR 2.65, p=0.002) and the vascular resection during PD was the only independent predictor for severe complications (OR 3.75, p=0.002). The other covariates including MPD dilatation, pancreatic fatty degeneration, sarcopenia, BMI, ASA grade were not predictive.
Conclusions : Preoperative cross-sectional imaging studies can provide informations regarding sarcopenic obesity and the necessity of combined vascular resection which are significant risk factors in the development of POPF and severe complication after pancreatoduodenectomy.
Methods : Body composition parameters including total abdominal muscle area and visceral fat area were assessed by preoperative CT in patients who underwent PD from 2005 to 2016 (Fig 1). Based on preoperative CT/MRIs, we evaluated the presence of main pancreatic duct (MPD) dilatation and pancreatic fatty degeneration as well. Perioperative variables and postoperative outcomes were collected from the medical records. The POPF were scored according to the ISGPF definition. The severe complications were defined as Clavien-Dindo class III and IV. Univariate and multivariate logistic regression analyses were performed.
Results : A total of 284 patients (163 male, 121 female) met the inclusion criteria. The POPF (grade II + III) rate was 18.3% (52/284) and severe complication rate was 12.0% (34/284). Mortality rate was 2.1% (6). In both univariate and multivariate analyses, the sarcopenic obesity was the only independent predictor for POPF (OR 2.65, p=0.002) and the vascular resection during PD was the only independent predictor for severe complications (OR 3.75, p=0.002). The other covariates including MPD dilatation, pancreatic fatty degeneration, sarcopenia, BMI, ASA grade were not predictive.
Conclusions : Preoperative cross-sectional imaging studies can provide informations regarding sarcopenic obesity and the necessity of combined vascular resection which are significant risk factors in the development of POPF and severe complication after pancreatoduodenectomy.
SESSION
Poster
Poster / Exhibition Hall and Lobby(2F) 1/1/1970 9:00 AM - 9:00 AM