Long‐term changes in body composition after pancreaticoduodenectomy

Aslani, Alireza; Roach, Paul; Smith, Ross C.

doi:10.1111/j.1445-2197.2011.05970.x

Cited by 9 publications

(8 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although few prior studies have characterized changes in either nutritional indices or body composition following pancreatectomy [29–32], the results of those studies, together with the data described herein, clearly document that adverse physiologic changes do occur and, more importantly, that they persist long after surgery. In this study, patients experienced a significant loss of weight and serum albumin, and a progressive depletion of both muscle and fat, in the year following PD.…”

Section: Discussionsupporting

confidence: 58%

“…In this study, patients experienced a significant loss of weight and serum albumin, and a progressive depletion of both muscle and fat, in the year following PD. In a study of physiologic changes that occurred in 27 patients during the first 6 months following PD, Aslani et al found that both fat mass and total body protein declined in the early postoperative period but by 6 months measures of protein (but not fat mass) returned to preoperative levels [29]. In a more recent study, Hashimoto et al found that 93 patients who underwent pancreatectomy had lost 8.4% of body weight at 2 months after surgery and 9% of body weight by 4 months [33].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anthropometric Changes in Patients with Pancreatic Cancer Undergoing Preoperative Therapy and Pancreatoduodenectomy

Cloyd

Nogueras‐González

Prakash

et al. 2018

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

Background The changes in body composition that occur in response to therapy for localized PDAC and during the early survivorship period, as well as their clinical significance, are poorly understood. Methods 127 consecutive patients with PDAC who received preoperative therapy followed by pancreatoduodenectomy at a single institution between 2009–2012 were longitudinally evaluated. Changes in skeletal muscle (SKM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were measured on serial computed tomography images obtained upon presentation, prior to pancreatectomy, and approximately 3 and 12 months after surgery. Results Prior to therapy, patients’ mean baseline BMI was 26.5±4.7 Kg/m2 and 63.0% met radiographic criteria for sarcopenia. During a mean 5.4±2.3 months of preoperative therapy, minimal changes in SKM (−0.5±7.8%, p>0.05), VAT (−1.8±62.6%, p<0.001), and SAT (−4.8±27.7%, p<0.001) were observed. In contrast, clinically significant changes were observed on post-operative CT compared to baseline anthropometry: SKM −4.1±10.7%, VAT −38.7±30.2%, and SAT −24.1±22.6% (all p<0.001) and these changes persisted at one year following PD. While anthropometric changes during preoperative therapy were not independently associated with survival, SKM gain between the postoperative period and one year follow-up was associated with improved overall survival (OR 0.50, 95% CI 0.29–0.87). Conclusions In contrast to the minor changes that occur during preoperative therapy for PDAC, significant losses in key anthropometric parameters tend to occur over the first year following PD. Ongoing SKM loss in the postoperative period may represent an early marker for worse outcomes.

show abstract

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Anthropometric Changes in Patients with Pancreatic Cancer Undergoing Preoperative Therapy and Pancreatoduodenectomy

Cloyd

Nogueras‐González

Prakash

et al. 2018

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

show abstract

“…Data from patients with PEI are currently limited, although one study in CF (97% of patients with PEI) assessing body composition by dual-energy Xray absorptiometry highlighted a reduction in fat-free mass that did not always correlate with changes in BMI percentile [46]. One group studied changes in body composition using in vivo neutron capture, bioelectrical impedance, skin-fold thickness and circumference after pancreaticoduodenectomy and observed significant drops in all markers in the first 3 months [47]. However, these studies did not sub-group patients by PEI status; therefore the reductions in muscle and fat stores cannot be correlated with PEI.…”

Section: Other Anthropometric Assessmentsmentioning

confidence: 95%

“…Data on the use of other anthropometric measures to assess PERT efficacy are limited. One study noted that PERT use starting 1 month after pancreaticoduodenectomy resulted in a return to pre-operative levels in total body protein, potassium and arm muscle area, but not fat mass, at 6 months [47].…”

Section: Other Anthropometric Assessmentsmentioning

confidence: 98%

“…Definition of percentage weight loss Unresectable or metastatic pancreatic adenocarcinoma [97] Total % body weight loss from onset of disease Pylorus-preserving pancreaticoduodenectomy [98] Ratio of post-operative weight at 6 months/pre-operative weight Pancreaticogastrostomy [99] Quantity of weight loss (no time scale specified) Whipple's procedure [47] Total weight loss Pancreatic cancer [100] Unintended weight loss over a period longer than 6 weeks, quantity unspecified Pancreatic cancer [45] % change in 100 days patients with PEI. The prevalence of laboratory nutritional marker abnormalities, including vitamins, minerals, trace elements and plasma proteins, has been investigated in several studies.…”

Section: Patient Populationmentioning

confidence: 99%

See 1 more Smart Citation

Clinical, anthropometric and laboratory nutritional markers of pancreatic exocrine insufficiency: Prevalence and diagnostic use

2015

View full text Add to dashboard Cite

Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy

et al. 2022

View full text Add to dashboard Cite

Objectives To investigate if different methods of pancreatoduodenectomy (with or without pyloric preservation) would have different impacts on postoperative nutrition and body composition changes among pancreatic cancer patients. Methods Demographic and clinicopathological data, perioperative data were collected, body composition (e.g. skeletal muscle cross‐sectional area [CSA], visceral fat area [VFA]) were evaluated with abdominal CT before and after surgery. Sarcopenia patients' proportion changes were also recorded. Results The hospital stay in the PRPD group was significantly less than that in the PPPD group ( p < 0.05). A significant difference was found in CSA, skeletal muscle index (SMI), VFA, VFA/CSA and albumin (ALB) in both groups between preoperative, 3, and 12 months after surgery. The loss of visceral fat in the PRPD group was more prominent than that in the PPPD group at 3 months and 12 months after surgery ( p < 0.05). VFA/CSA was higher in the PPPD group than in the PRPD group (3 months: p < 0.05, 12 months: p < 0.001). The proportion of sarcopenic patients increased significantly over time in the PPPD and PRPD groups ( p < 0.001). Conclusions Postoperative CSA and VFA continued to significantly decrease in both PPPD and PRPD groups, while the incidence of sarcopenia continued to increase. Compared with PRPD, PPPD has a protective effect on visceral fat. PPPD may contribute to better maintaining visceral fat mass and blood ALB levels. CT quantification can be an objective and effective method to evaluate the nutritional status of pancreatic cancer patients during the pre‐ and postoperative period and can provide a useful objective basis for guiding clinical treatment.

show abstract

Long‐term changes in body composition after pancreaticoduodenectomy

Cited by 9 publications

References 35 publications

Anthropometric Changes in Patients with Pancreatic Cancer Undergoing Preoperative Therapy and Pancreatoduodenectomy

Anthropometric Changes in Patients with Pancreatic Cancer Undergoing Preoperative Therapy and Pancreatoduodenectomy

Clinical, anthropometric and laboratory nutritional markers of pancreatic exocrine insufficiency: Prevalence and diagnostic use

Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy

Contact Info

Product

Resources

About