Hiroaki Yamane1, Tomoyuki Abe2, Hironobu Amano1,3, Keiji Hanada4, Tomoyuki Minami4, Tsuyoshi Kobayashi3, Toshikatsu Fukuda5, Shuji Yonehara6, Masahiro Nakahara1, Hideki Ohdan3, Toshio Noriyuki1,3. 1. Department of Surgery, Onomichi General Hospital, Onomichi, Japan. 2. Department of Surgery, Onomichi General Hospital, Onomichi, Japan t.abe.hiroshima@gmail.com. 3. Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. 4. Department of Gastroenterology, Onomichi General Hospital, Onomichi, Japan. 5. Department of Surgery, Hiroshima General Hospital of West Japan Railway Company, Hiroshima, Japan. 6. Department of Pathology, Onomichi General Hospital, Onomichi, Japan.
Abstract
BACKGROUND/AIM: In this study, we investigated the effect of body composition on pancreatic fistula (PF) development after pancreaticoduodenectomy (PD). MATERIALS AND METHODS: All consecutive patients with pancreatic and extrahepatic biliary malignancy following PD who were treated between 2006 and 2016 were enrolled. RESULTS: PF developed in 30.3% of cases (30/99 patients), including a grade B PF in 25.3% of cases (25/99 patients) and a grade C PF in 5.1% of cases (5/99 patients). Univariate analysis identified that body mass index ≥25 kg/m2, visceral adipose tissue area (VATA)/skeletal muscle index (SMI) ≥2.0, pancreatic duct diameter ≤3 mm, and drain amylase concentration (Amy) on postoperative day (POD) 1 ≥5000 U/L were significantly associated with PF (grade B, C) after PD. Multivariate analysis indicated that VATA/SMI ≥2.0 (p=0.009), pancreatic duct diameter ≤3 mm (p=0.003), and drain Amy on POD1 ≥5000 U/L (p=0.032) were independent risk factors for PF. CONCLUSION: Elevated VATA/SMI was the only preoperative key factor for PF after PD. Copyright
BACKGROUND/AIM: In this study, we investigated the effect of body composition on pancreatic fistula (PF) development after pancreaticoduodenectomy (PD). MATERIALS AND METHODS: All consecutive patients with pancreatic and extrahepatic biliary malignancy following PD who were treated between 2006 and 2016 were enrolled. RESULTS: PF developed in 30.3% of cases (30/99 patients), including a grade B PF in 25.3% of cases (25/99 patients) and a grade C PF in 5.1% of cases (5/99 patients). Univariate analysis identified that body mass index ≥25 kg/m2, visceral adipose tissue area (VATA)/skeletal muscle index (SMI) ≥2.0, pancreatic duct diameter ≤3 mm, and drain amylase concentration (Amy) on postoperative day (POD) 1 ≥5000 U/L were significantly associated with PF (grade B, C) after PD. Multivariate analysis indicated that VATA/SMI ≥2.0 (p=0.009), pancreatic duct diameter ≤3 mm (p=0.003), and drain Amy on POD1 ≥5000 U/L (p=0.032) were independent risk factors for PF. CONCLUSION: Elevated VATA/SMI was the only preoperative key factor for PF after PD. Copyright