Impact of sarcopenic obesity on post-hepatectomy bile leakage for hepatocellular carcinoma

Abstract

Background: Post-hepatectomy bile leakage (PHBL) is a potentially fatal complication that can arise after hepatectomy. Previous studies have identified obesity as a risk factor for PHBL. Therefore, we investigated the impact of sarcopenic obesity on PHBL in hepatocellular carcinoma (HCC) patients. Methods: In total, we enrolled 409 patients who underwent hepatectomy without bilioenteric anastomosis for HCC between January 2010 and August 2021. Patients were grouped according to the presence or absence of PHBL. Patient characteristics including body mass index and sarcopenic obesity were then analyzed for predictive factors for PHBL. Results: Among the 409 HCC patients included in this study, 39 developed PHBL. Male gender, hypertension and cardiac disease, white blood cell counts, the psoas muscle area and visceral fat area, and intraoperative blood loss were significantly increased in the PHBL (+) group compared with the PHBL (−) group. Multivariate analysis showed that independent risk factors for the occurrence of PHBL were intraoperative blood loss ≥370 mL and sarcopenic obesity. Conclusion: Our results show that it is important to understand whether a patient is at high risk for PHBL prior to surgery and especially to reduce intraoperative blood loss during surgery for patients with risk factors for PHBL.