COMBINING ASSESSMENT OF MUSCLE STRENGTH WITH MYOPENIA BETTER PREDICTS EARLY POSTOPERATIVE COMPLICATIONS AFTER PANCREATICODUODENECTOMY

肌力评估与肌少症相结合能更好地预测胰十二指肠切除术后的早期并发症

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Abstract

BACKGROUND: Pancreaticoduodenectomy (PD) is a complex procedure with significant postoperative morbidity. Associated sarcopenia could be a potential risk for increased post-operative complications. METHODS: Patients who had undergone pancreaticoduodenectomy bet-ween July 2019 to December 2020 were included in the study. Preope-rative comprehensive sarcopenia assessment was done by hand grip strength test, Dual energy X-ray absorptiometry (DEXA) scan and gait speed test. Only myopenia was also assessed by DEXA scan in all the patients. Post-operative outcomes were recorded and the association of preoperative sarcopenia with postoperative complications were analyzed. RESULTS: Of 47 patients assessed, 36 patients were finally included (Median age -58 years (IQR-51,68) years, 26 male). The five (13.8%) had sarcopenia confirmed on comprehensive assessment. Thirteen (36.5%) patients had myopenia on DEXA assessment. The major Clavien-Dindo complications were significantly higher in sarcopenia (40% vs 6.6%, P=0.04) and similarly, grade C DGE (40% vs 0, P=0.04) was also more frequent in patients with sarcopenia. The patients with myopenia only did not have a significant correlation with post-operative complications. (15.4% vs 8.7% P=0.66). CONCLUSION: Comprehensive assessment using muscle strength and muscle quantity is essential for sarcopenia diagnosis. Preoperative sarcopenia is a significant risk factor for post-operative complications.

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