Background: Recently, skeletal muscle depletion (sarcopenia) has been reported to influence postoperative\noutcomes after certain procedures. This study investigated the impact of sarcopenia on postoperative outcomes\nfollowing pancreaticoduodenectomy (PD).\nMethods: We performed a retrospective study of consecutive patients (n = 219) who underwent PD at our\ninstitution between January 2007 and May 2013. Sarcopenia was evaluated using preoperative computed\ntomography. We evaluated postoperative outcomes and the influence of sarcopenia on short-term outcomes,\nespecially infectious complications. Subsequently, multivariate analysis was used to assess the impact of prognostic\nfactors (including sarcopenia) on postoperative infections.\nResults: The mortality, major complication, and infectious complication rates for all patients were 1.4%, 16.4%, and\n47.0%, respectively. Fifty-five patients met the criteria for sarcopenia. Sarcopenia was significantly associated with a\nhigher incidence of in-hospital mortality (P = 0.004) and infectious complications (P < 0.001). In multivariate\nanalyses, sarcopenia (odds ratio = 3.43; P < 0.001), preoperative biliary drainage (odds ratio = 2.20; P = 0.014), blood\nloss (odds ratio = 1.92; P = 0.048), and soft pancreatic texture (odds ratio = 3.71; P < 0.001) were independent\npredictors of postoperative infections.\nConclusions: Sarcopenia is an independent preoperative predictor of infectious complications after PD. Clinical\nassessment combined with sarcopenia may be helpful for understanding the risk of postoperative outcomes and\ndetermining perioperative management strategies.
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