Detailed Abstract
[BP Best Oral Presentation]
[BP BEST OP 2] Adverse effect of sarcopenic obesity on postoperative complications after major hepatectomy in patients with hilar cholangiocarcinoma
Youngju RYU1, Chang-Sup LIM2, Yong Chan SHIN3, Naru KIM1, Yung hun YOU1, Sang Hyun SHIN1, Jin Seok HEO1, Dong Wook CHOI1, In Woong HAN*1
1Division of Hepatobiliary-Pancreatic surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Surgery, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea
3Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
Introduction : Recently, it is well known that sarcopenia is one of the risk factors on post-hepatectomy outcomes in patients with hepatocellular carcinoma. However, there were seldom reports for effect of sarcopenia or sarcopenic obesity (SO) on postoperative outcomes in patients with perihilar cholangiocarcinoma (CCC). The purpose of this study is to evaluate the effect of preoperative sarcopenia or SO on postoperative outcomes in patients with hilar CCC following major heptectomy.
Methods : Preoperative sarcopenia and SO was assessed in 328 patients undergoing hepatectomy for hilar CCC at three institution between 2006 and 2016, retrospectively. The sarcopenia was calculated from cross-sectional visceral fat and muscle area on preoperative CT imaging (muscle area/height2 = skeletal muscle index, SMI). SO was defined by visceral fat area/SMI.
Results : Preoperative sarcopenia and SO was present in 97 (29.6%) and 98 (29.9%) of the patients. Preoperative sarcopenia itself was not associated with postoperative outcomes. However, the rate of major complication in patients with SO was higher than in those without SO (54.1 vs. 37.0%, p=0.004). Also, postoperative hospital stay was prolonged in patients with SO (18.5 vs. 16.5 days, p=0.038). After multivariable analysis, male sex (OR1.937, 95%CI:1.182-3.174, p=0.009) and SO (OR1.866, 95%CI:1.148-3.034, p=0.012) were independent risk factors for occurrence of major complication. There was no statistically significant in overall survival with sarcopenia or SO.
Conclusions : SO was an independent risk factor of major complication after hepatectomy in hilar CCC. As a result, careful postoperative management would be needed after major hepatectomy in patients with hilar CCC in case of SO.
Methods : Preoperative sarcopenia and SO was assessed in 328 patients undergoing hepatectomy for hilar CCC at three institution between 2006 and 2016, retrospectively. The sarcopenia was calculated from cross-sectional visceral fat and muscle area on preoperative CT imaging (muscle area/height2 = skeletal muscle index, SMI). SO was defined by visceral fat area/SMI.
Results : Preoperative sarcopenia and SO was present in 97 (29.6%) and 98 (29.9%) of the patients. Preoperative sarcopenia itself was not associated with postoperative outcomes. However, the rate of major complication in patients with SO was higher than in those without SO (54.1 vs. 37.0%, p=0.004). Also, postoperative hospital stay was prolonged in patients with SO (18.5 vs. 16.5 days, p=0.038). After multivariable analysis, male sex (OR1.937, 95%CI:1.182-3.174, p=0.009) and SO (OR1.866, 95%CI:1.148-3.034, p=0.012) were independent risk factors for occurrence of major complication. There was no statistically significant in overall survival with sarcopenia or SO.
Conclusions : SO was an independent risk factor of major complication after hepatectomy in hilar CCC. As a result, careful postoperative management would be needed after major hepatectomy in patients with hilar CCC in case of SO.
SESSION
BP Best Oral Presentation
Room B 7/28/2020 1:50 PM - 2:00 PM