Visceral Adipose Tissue and Skeletal Muscle Index Distribution Predicts Severe Pancreatic Fistula Development After Pancreaticoduodenectomy.

BACKGROUND/AIM: In this study, we investigated the effect of body composition on pancreatic fistula (PF) development after pancreaticoduodenectomy (PD).

MATERIALS AND

METHODS

All consecutive patients with pancreatic and extrahepatic biliary malignancy following PD who were treated between 2006 and 2016 were enrolled.

RESULTS

PF developed in 30.3% of cases (30/99 patients), including a grade B PF in 25.3% of cases (25/99 patients) and a grade C PF in 5.1% of cases (5/99 patients). Univariate analysis identified that body mass index ≥25 kg/m2, visceral adipose tissue area (VATA)/skeletal muscle index (SMI) ≥2.0, pancreatic duct diameter ≤3 mm, and drain amylase concentration (Amy) on postoperative day (POD) 1 ≥5000 U/L were significantly associated with PF (grade B, C) after PD. Multivariate analysis indicated that VATA/SMI ≥2.0 (p=0.009), pancreatic duct diameter ≤3 mm (p=0.003), and drain Amy on POD1 ≥5000 U/L (p=0.032) were independent risk factors for PF.

CONCLUSION

Elevated VATA/SMI was the only preoperative key factor for PF after PD.