Sarcopenia is an independent predictor of delayed gastric emptying following pancreaticoduodenectomy: a retrospective study

Abstract

Background: The pathogenesis of delayed gastric emptying (DGE), a common complication of pancreaticoduodenectomy, is unclear. Loss of skeletal muscle mass (sarcopenia) is associated with post-pancreaticoduodenectomy complications; however, few studies have investigated the relationship between sarcopenia and DGE. The aim of this study was to investigate whether post-pancreaticoduodenectomy DGE is affected by pre-operative skeletal muscle mass. Methods: We retrospectively analysed the data of 112 consecutive patients who had undergone pancreaticoduodenectomy and divided them into the following two groups: no DGE (n = 100) and with DGE (n = 12). Patients were stratified by quartiles according to each element of body composition. The lowest quartile for skeletal muscle mass was defined as having sarcopenia. Results: Ten and two patients had grades B and C DGE, respectively. According to univariate analysis, body mass index (P = 0.031), clinically relevant post-operative pancreatic fistula (P < 0.001) and skeletal muscle mass (P = 0.002) were significantly associated with DGE. According to multivariate analysis, high body mass index (≥25 kg/cm 2 ) (P = 0.005), post-operative pancreatic fistula (P = 0.027) and low skeletal muscle mass (P = 0.004) were independently associated with DGE. Conclusion: Sarcopenia is an independent predictor of DGE after pancreaticoduodenectomy. © 2019 Royal Australasian College of Surgeons ANZ J Surg 89 (2019) E433-E437 ANZJSurg.com © 2019 Royal Australasian College of Surgeons E436 Shintakuya et al.

Association between preoperative lumbar skeletal muscle index and postoperative nausea and vomiting in patients undergoing pylorus-preserving pancreatoduodenectomy: a retrospective study

“…Postoperative ileus is a common complication. Previous studies have demonstrated a relationship between sarcopenia and delayed gastric emptying in patients undergoing PPPD [ 29 , 30 ], which could be one possible reason for increased risk of PONV in sarcopenic patients in current study. An association between sarcopenia and nausea has been reported in patients with cancer undergoing chemotherapy.…”

Impact of sarcopenia on recurrent biliary obstruction after EUS-guided biliary drainage in patients with malignant biliary obstruction

“…First, most patients with severe sarcopenia have low physical activity, which is associated with impaired gallbladder motility, leading to increased prevalences of gallstones (including sludge) and RBO 39,40 . Second, Sarcopenia is an independent predictor of delayed gastric emptying, leading to increased prevalences of food impaction and RBO 41 . Third, sarcopenia is a signi cant predictor of poor chemosensitivity and survival in patients with unresectable cancer.…”