Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 131] Impact of Sarcopenia on Surgical Outcomes in Patients Undergoing Pancreaticoduodenectomy (PD): a Teritiary Care Center Experience in ODISHA- INDIA .
Dr. Swamy Rajesh HUDUDGUR 1, Dr. Satyaprakash RAY CHUDHURY 1, Dr. Jyotirmay JENA 1, Dr. Sumit S MOHANTY 1
1 Department of Surgical Gastroenterology , IMS & SUM Hospital , INDIA
Background : sarcopenia is common in pancreatic cancer and influence postoperative outcomes. Studies show perioperative complications, mortality, worse survival increase with sarcopenia. Aim: To study association of preoperative Sarcopenia with immediate & delayed postoperative complications & surgical outcome in patients undergoing Pancreaticoduodenectomy(PD).
Methods : A single center, Prospective Study from Jan 2022 to July 2023. All patients of suspected periampullary & HOP malignancies included and investigations done to establish diagnosis, operability. Pts assessed for BMI , MAC , Hand grip test and CT analysis – skeletal muscle area(SMA) at L3 vertebrae & L3 SMI (skeletal muscle index). Cut off for sarcopenia: <36.5 cm2/m2(males) and <30.2 cm2/m2(Females) taken.
Results : Total 57 patients underwent PD, 45.6% are females, and 54.3% males. 26 (45.6%) [12(45.16%) female, 14 (53.8%) male] have sarcopenia. The mean age was 58.59. The mean SMI Index in sarcopenia group (30.86±3.39)(P value <0.001), SMI values [(33.78±3.28) vs(43.2± 1.49)]male, [(27.45±1.84) vs (36.92±0.96)]female. Preop Biliary drainage required in 15(57.6% vs 8(25.8%) (p=0.0147).Sarcopenic patients are associated with low albumin levels - 3.269(±0.349)(p=0.0086) ,mid-arm circumference [24.86±4.9cm(p value <0.001)], Handgrip strength values [32.21±9.3(p value0.011)].In sarcopenia group (n=26), 10(38.46%)pancreatic leak(CR-POPF), 6(23%)bile leak, 10(38.46%)DGE , total 20(76.9%) cases had late complications. ICU stay, hospital stay, Infective complications[11(45.45%)(p value 0.029)] were higher in sarcopenia group. On multivariate analysis low serum albumin <3.5(p<0.038), sarcopenia (p=0.036) were significant.
Conclusions : Sarcopenia is associated with adverse postoperative outcomes and represent independent risk factor for infectious complications after PD. Identifying sarcopenia patients before surgery enable to implement prehabilitation and targeted interventions to optimize and enhance surgical outcomes.
Methods : A single center, Prospective Study from Jan 2022 to July 2023. All patients of suspected periampullary & HOP malignancies included and investigations done to establish diagnosis, operability. Pts assessed for BMI , MAC , Hand grip test and CT analysis – skeletal muscle area(SMA) at L3 vertebrae & L3 SMI (skeletal muscle index). Cut off for sarcopenia: <36.5 cm2/m2(males) and <30.2 cm2/m2(Females) taken.
Results : Total 57 patients underwent PD, 45.6% are females, and 54.3% males. 26 (45.6%) [12(45.16%) female, 14 (53.8%) male] have sarcopenia. The mean age was 58.59. The mean SMI Index in sarcopenia group (30.86±3.39)(P value <0.001), SMI values [(33.78±3.28) vs(43.2± 1.49)]male, [(27.45±1.84) vs (36.92±0.96)]female. Preop Biliary drainage required in 15(57.6% vs 8(25.8%) (p=0.0147).Sarcopenic patients are associated with low albumin levels - 3.269(±0.349)(p=0.0086) ,mid-arm circumference [24.86±4.9cm(p value <0.001)], Handgrip strength values [32.21±9.3(p value0.011)].In sarcopenia group (n=26), 10(38.46%)pancreatic leak(CR-POPF), 6(23%)bile leak, 10(38.46%)DGE , total 20(76.9%) cases had late complications. ICU stay, hospital stay, Infective complications[11(45.45%)(p value 0.029)] were higher in sarcopenia group. On multivariate analysis low serum albumin <3.5(p<0.038), sarcopenia (p=0.036) were significant.
Conclusions : Sarcopenia is associated with adverse postoperative outcomes and represent independent risk factor for infectious complications after PD. Identifying sarcopenia patients before surgery enable to implement prehabilitation and targeted interventions to optimize and enhance surgical outcomes.
SESSION
E-poster
E-Session 03/21 ALL DAY