Effects of nutritional status on short-term prognosis after minimally invasive pancreaticoduodenectomy

Abstract Minimally invasive pancreaticoduodenectomy (MIPD) has been routinely performed in major centers, and its feasibility and efficacy in tumor treatment have been highly recognized. Malnutrition has been associated with higher rates of morbidity, and increased mortality in surgical patients. Th...

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Main Authors: Zheyu Xu, Jingtao Chen, Yiping Mou, Ou Li, Yucheng Zhou
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-81016-7
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author Zheyu Xu
Jingtao Chen
Yiping Mou
Ou Li
Yucheng Zhou
author_facet Zheyu Xu
Jingtao Chen
Yiping Mou
Ou Li
Yucheng Zhou
author_sort Zheyu Xu
collection DOAJ
description Abstract Minimally invasive pancreaticoduodenectomy (MIPD) has been routinely performed in major centers, and its feasibility and efficacy in tumor treatment have been highly recognized. Malnutrition has been associated with higher rates of morbidity, and increased mortality in surgical patients. The effect of the nutritional status on MIPD outcomes still remains unclear and controversial. The clinical data of 207 consecutive patients who had MIPD between June 2017 and December 2022 were retrospectively analyzed. A multidimensional nutrition assessment was performed before surgery. Multivariable analysis and propensity score matching (PSM) was performed to identify the association of preoperative nutritional status on postoperative short-term prognosis(Morbidity–Mortality, Clavien-Dindo classification ≥ IIIa, postoperative pancreatic fistulas and biliary fistula). In the multivariable analysis, sarcopenia (OR 9.74, 95% CI 3.34–43.03) was associated with postoperative morbidity and sarcopenia (OR 6.74, 95% CI 2.24–30.24) was associated with major complications. In the cohort after PSM, sarcopenia remained independently associated with morbidity (OR 12.44, 95% CI 3.72- 59.16) and major complications (OR 8.14, 95% CI 2.13- 43.83). Sarcopenia before MIPD has an impact on postoperative outcomes. Nutritional status assessment, especially sarcopenia, should be part of the routine preoperative procedures to provide early and appropriate nutritional support for MIPD patients.
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spelling doaj-art-03bbeda59e604b0c811ed6ae95e554652025-08-20T02:10:46ZengNature PortfolioScientific Reports2045-23222024-11-011411910.1038/s41598-024-81016-7Effects of nutritional status on short-term prognosis after minimally invasive pancreaticoduodenectomyZheyu Xu0Jingtao Chen1Yiping Mou2Ou Li3Yucheng Zhou4Department of Gastroenterology & Pancreatic Surgery, Zhejiang Province People’s HospitalDepartment of Gastroenterology & Pancreatic Surgery, Zhejiang Province People’s HospitalDepartment of Gastroenterology & Pancreatic Surgery, Zhejiang Province People’s HospitalDepartment of Gastroenterology & Pancreatic Surgery, Zhejiang Province People’s HospitalDepartment of Gastroenterology & Pancreatic Surgery, Zhejiang Province People’s HospitalAbstract Minimally invasive pancreaticoduodenectomy (MIPD) has been routinely performed in major centers, and its feasibility and efficacy in tumor treatment have been highly recognized. Malnutrition has been associated with higher rates of morbidity, and increased mortality in surgical patients. The effect of the nutritional status on MIPD outcomes still remains unclear and controversial. The clinical data of 207 consecutive patients who had MIPD between June 2017 and December 2022 were retrospectively analyzed. A multidimensional nutrition assessment was performed before surgery. Multivariable analysis and propensity score matching (PSM) was performed to identify the association of preoperative nutritional status on postoperative short-term prognosis(Morbidity–Mortality, Clavien-Dindo classification ≥ IIIa, postoperative pancreatic fistulas and biliary fistula). In the multivariable analysis, sarcopenia (OR 9.74, 95% CI 3.34–43.03) was associated with postoperative morbidity and sarcopenia (OR 6.74, 95% CI 2.24–30.24) was associated with major complications. In the cohort after PSM, sarcopenia remained independently associated with morbidity (OR 12.44, 95% CI 3.72- 59.16) and major complications (OR 8.14, 95% CI 2.13- 43.83). Sarcopenia before MIPD has an impact on postoperative outcomes. Nutritional status assessment, especially sarcopenia, should be part of the routine preoperative procedures to provide early and appropriate nutritional support for MIPD patients.https://doi.org/10.1038/s41598-024-81016-7Minimally invasive pancreaticoduodenectomyNutritional statusSarcopeniaWeight lossMorbidity
spellingShingle Zheyu Xu
Jingtao Chen
Yiping Mou
Ou Li
Yucheng Zhou
Effects of nutritional status on short-term prognosis after minimally invasive pancreaticoduodenectomy
Scientific Reports
Minimally invasive pancreaticoduodenectomy
Nutritional status
Sarcopenia
Weight loss
Morbidity
title Effects of nutritional status on short-term prognosis after minimally invasive pancreaticoduodenectomy
title_full Effects of nutritional status on short-term prognosis after minimally invasive pancreaticoduodenectomy
title_fullStr Effects of nutritional status on short-term prognosis after minimally invasive pancreaticoduodenectomy
title_full_unstemmed Effects of nutritional status on short-term prognosis after minimally invasive pancreaticoduodenectomy
title_short Effects of nutritional status on short-term prognosis after minimally invasive pancreaticoduodenectomy
title_sort effects of nutritional status on short term prognosis after minimally invasive pancreaticoduodenectomy
topic Minimally invasive pancreaticoduodenectomy
Nutritional status
Sarcopenia
Weight loss
Morbidity
url https://doi.org/10.1038/s41598-024-81016-7
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