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World Journal of Surgery

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01-06-2015 | Original Scientific Report

Preoperative Sarcopenia Negatively Impacts Postoperative Outcomes Following Major Hepatectomy with Extrahepatic Bile Duct Resection

Authors: Hidehiko Otsuji, Yukihiro Yokoyama, Tomoki Ebata, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Masato Nagino

Published in: World Journal of Surgery | Issue 6/2015

Abstract

Background

Major hepatectomy with extrahepatic bile duct resection for perihilar cholangiocarcinoma remains a highly morbid procedure. The association between preoperative sarcopenia and postoperative morbidity/mortality has been reported for various types of surgeries. The objective was to analyze the relationship between preoperative sarcopenia and postoperative morbidity/mortality in patients who underwent major hepatectomy with extrahepatic bile duct resection.

Methods

This study included 256 patients who underwent major hepatectomy with extrahepatic bile duct resection from 2008 to 2014. Preoperative sarcopenia was assessed by a measurement of the total psoas muscle area (TPA). The measured TPA was normalized by height. Preoperative sarcopenia was defined as the presence of a normalized TPA in the lowest sex-specific tertile.

Results

A total of 54 males and 31 females were determined to have preoperative sarcopenia. The length of the postoperative hospital stay for patients with sarcopenia was significantly longer than for those without sarcopenia (39 vs 30 days, p < 0.001). Patients with sarcopenia experienced a significantly higher rate of liver failure (ISGLS grade ≥ B) (33 vs 16 %), major complications with Clavien grade ≥ 3 (54 vs 37 %), and intra-abdominal abscess (29 vs 18 %) than those without sarcopenia (all p < 0.05). After a multivariate analysis, low normalized TPA (male <567 mm²/m²; female <395 mm²/m²) was identified as an independent risk factor for the development of liver failure (odds ratio 2.46).

Conclusions

This study demonstrated that preoperative sarcopenia increased the morbidity rate including the rate of liver failure, in patients who underwent major hepatectomy with extrahepatic bile duct resection.

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Title: Preoperative Sarcopenia Negatively Impacts Postoperative Outcomes Following Major Hepatectomy with Extrahepatic Bile Duct Resection
Authors: Hidehiko Otsuji
Yukihiro Yokoyama
Tomoki Ebata
Tsuyoshi Igami
Gen Sugawara
Takashi Mizuno
Masato Nagino
Publication date: 01-06-2015
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 6/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-2988-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Preoperative Sarcopenia Negatively Impacts Postoperative Outcomes Following Major Hepatectomy with Extrahepatic Bile Duct Resection

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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