Adverse Effects of Sarcopenic Obesity on Postoperative Complications after Major Hepatectomy in Patients with Hilar Cholangiocarcinoma

Sarcopenic obesity (SO), which is defined as a high ratio of visceral adipose tissue to skeletal muscle, is a well-known risk factor for post-hepatectomy outcomes in patients with hepatocellular carcinoma. However, few studies have evaluated the effect of SO on postoperative outcomes in patients wit...

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Published inJournal of clinical medicine Vol. 11; no. 7; p. 1860
Main Authors Lee, Okjoo, Shin, Yong Chan, Ryu, Youngju, Shin, Sang Hyun, Heo, Jin Seok, Lim, Chang-Sup, Han, In Woong
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 27.03.2022
MDPI
Subjects
Abdomen
Body composition
Body fat
Cancer
Cholangiocarcinoma
Clinical medicine
Hepatectomy
Hospitals
Liver cancer
Medical imaging
Medical prognosis
Mortality
Musculoskeletal system
Obesity
Patients
Postoperative period
Risk factors
Sarcopenia
Surgery
Surgical outcomes
Tomography
Veins & arteries
United States > US
sarcopenic obesity
postoperative complication
hilar cholangiocarcinoma
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Summary:Sarcopenic obesity (SO), which is defined as a high ratio of visceral adipose tissue to skeletal muscle, is a well-known risk factor for post-hepatectomy outcomes in patients with hepatocellular carcinoma. However, few studies have evaluated the effect of SO on postoperative outcomes in patients with hilar cholangiocarcinoma (CCC). This retrospective study aimed to evaluate the effect of preoperative SO on postoperative outcomes in patients with hilar CCC following major hepatectomy. Preoperative SO was assessed in 328 patients undergoing hepatectomy for hilar CCC at three institutions between 2006 and 2016. SO was calculated from cross-sectional visceral fat and muscle area displayed on preoperative CT imaging. Preoperative SO was present in 98 patients (29.9%). The major complication rate in patients with SO was higher than in those without SO (54.1% vs. 37.0%, 0.004). Additionally, postoperative hospital stays were prolonged in patients with SO (18.5 vs. 16.5 days, 0.038). After multivariable analysis, SO was identified as an independent risk factor for major complications after hepatectomy in hilar CCC patients (OR = 0.866, 95% CI: 1.148-3.034, 0.012). Careful postoperative management is needed after major hepatectomy in hilar CCC patients with SO.
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These authors contributed equally to this work.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11071860