Shintakuya Ryuta, Sasaki Masaru, Nakamitsu Atsushi, Kohyama Mohei, Tazaki Tatsuya, Sugiyama Yoichi, Hirano Toshinori, Kaiki Yuki
Department of Surgery, JA Hiroshima General Hospital, Hatsukaichi, Hiroshima, Japan.
ANZ J Surg. 2019 Oct;89(10):E433-E437. doi: 10.1111/ans.15379. Epub 2019 Aug 26.
The pathogenesis of delayed gastric emptying (DGE), a common complication of pancreaticoduodenectomy, is unclear. Loss of skeletal muscle mass (sarcopenia) is associated with post-pancreaticoduodenectomy complications; however, few studies have investigated the relationship between sarcopenia and DGE. The aim of this study was to investigate whether post-pancreaticoduodenectomy DGE is affected by pre-operative skeletal muscle mass.
We retrospectively analysed the data of 112 consecutive patients who had undergone pancreaticoduodenectomy and divided them into the following two groups: no DGE (n = 100) and with DGE (n = 12). Patients were stratified by quartiles according to each element of body composition. The lowest quartile for skeletal muscle mass was defined as having sarcopenia.
Ten and two patients had grades B and C DGE, respectively. According to univariate analysis, body mass index (P = 0.031), clinically relevant post-operative pancreatic fistula (P < 0.001) and skeletal muscle mass (P = 0.002) were significantly associated with DGE. According to multivariate analysis, high body mass index (≥25 kg/cm ) (P = 0.005), post-operative pancreatic fistula (P = 0.027) and low skeletal muscle mass (P = 0.004) were independently associated with DGE.
Sarcopenia is an independent predictor of DGE after pancreaticoduodenectomy.
胃排空延迟(DGE)是胰十二指肠切除术常见的并发症,其发病机制尚不清楚。骨骼肌量减少(肌肉减少症)与胰十二指肠切除术后并发症相关;然而,很少有研究探讨肌肉减少症与DGE之间的关系。本研究的目的是调查胰十二指肠切除术后DGE是否受术前骨骼肌量的影响。
我们回顾性分析了112例连续接受胰十二指肠切除术患者的数据,并将他们分为以下两组:无DGE组(n = 100)和有DGE组(n = 12)。根据身体组成的每个元素将患者按四分位数分层。骨骼肌量最低的四分位数被定义为患有肌肉减少症。
分别有10例和2例患者发生B级和C级DGE。单因素分析显示,体重指数(P = 0.031)、临床相关的术后胰瘘(P < 0.001)和骨骼肌量(P = 0.002)与DGE显著相关。多因素分析显示,高体重指数(≥25kg/cm²)(P = 0.005)、术后胰瘘(P = 0.027)和低骨骼肌量(P = 0.004)与DGE独立相关。
肌肉减少症是胰十二指肠切除术后DGE的独立预测因素。