Preoperative risk factors for skeletal muscle mass loss in patients with biliary tract cancer

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-06-06 DOI:10.1002/jhbp.12006

Ryo Sugiura, Masaki Kuwatani, Kazumichi Kawakubo, Kazuma Kishi, Hiroki Yonemura, Shunichiro Nozawa, Masatsugu Ohara, Takehiro Noji, Satoshi Hirano, Naoya Sakamoto

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Abstract

Background

Endoscopic retrograde cholangiography (ERC)-related procedures, usually performed before biliary tract cancer (BTC) surgery, are associated with increased risk for various complications, which can cause sarcopenia. No study has previously elucidated the relationship between preoperative ERC-related procedures and sarcopenia/skeletal muscle mass loss.

Methods

Patients with BTC who underwent radical surgical resection following ERC-related procedures were included. Skeletal muscle mass was evaluated using the psoas muscle mass index (PMI), which was determined using computed tomography images, and the change in PMI before the initial pre-ERC and surgery (ΔPMI) was calculated. Risk factors for advanced skeletal muscle mass loss, defined as a large ΔPMI, were evaluated.

Results

The study cohort included 90 patients with a median age of 72 (interquartile range, 65–75) years. The median PMI pre-ERC and surgery was 4.40 and 4.15 cm²/m², respectively (p < .01). The median ΔPMI was −6.2% (interquartile range, −10.9% to 0.5%). By multivariate analysis, post-ERC pancreatitis and cholangitis before surgery were independent predictive factors for large PMI loss (odds ratio, 4.57 and 3.18, respectively; p = .03 and p = .02, respectively).

Conclusions

Skeletal muscle mass decreases preoperatively in most patients with BTC undergoing ERC. Post-ERC pancreatitis and cholangitis before surgery were independent risk factors for large skeletal muscle mass loss.

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胆道癌患者术前骨骼肌质量下降的风险因素。

背景：内镜逆行性胆管造影（ERC）相关手术通常在胆道癌（BTC）手术前进行，会增加各种并发症的风险，从而导致肌肉疏松症。此前还没有研究阐明术前 ERC 相关手术与肌肉疏松症/骨骼肌质量下降之间的关系：方法：纳入在进行 ERC 相关手术后接受根治性手术切除的 BTC 患者。骨骼肌质量通过腰肌质量指数（PMI）进行评估，腰肌质量指数是通过计算机断层扫描图像确定的，并计算最初的 ERC 前和手术前腰肌质量指数的变化（ΔPMI）。研究评估了晚期骨骼肌质量损失（定义为较大的ΔPMI）的风险因素：研究队列包括 90 名患者，中位年龄为 72 岁（四分位距为 65-75 岁）。ERC前和手术前的PMI中位数分别为4.40和4.15 cm2/m2（P 结论：ERC前和手术前的PMI中位数分别为4.40和4.15 cm2/m2：大多数接受 ERC 的 BTC 患者术前骨骼肌质量会下降。ERC术后胰腺炎和术前胆管炎是导致骨骼肌质量大幅下降的独立风险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.