Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy

Abstract Objectives To investigate if different methods of pancreatoduodenectomy (with or without pyloric preservation) would have different impacts on postoperative nutrition and body composition changes among pancreatic cancer patients. Methods Demographic and clinicopathological data, perioperati...

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Main Authors: Qianna Jin, Qianqian Ren, Xiaona Chang, Xiaoming Lu, Guobin Wang, Nan He
Format: Article
Language:English
Published: Wiley 2023-02-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.5155
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author Qianna Jin
Qianqian Ren
Xiaona Chang
Xiaoming Lu
Guobin Wang
Nan He
author_facet Qianna Jin
Qianqian Ren
Xiaona Chang
Xiaoming Lu
Guobin Wang
Nan He
author_sort Qianna Jin
collection DOAJ
description Abstract Objectives To investigate if different methods of pancreatoduodenectomy (with or without pyloric preservation) would have different impacts on postoperative nutrition and body composition changes among pancreatic cancer patients. Methods Demographic and clinicopathological data, perioperative data were collected, body composition (e.g. skeletal muscle cross‐sectional area [CSA], visceral fat area [VFA]) were evaluated with abdominal CT before and after surgery. Sarcopenia patients' proportion changes were also recorded. Results The hospital stay in the PRPD group was significantly less than that in the PPPD group (p < 0.05). A significant difference was found in CSA, skeletal muscle index (SMI), VFA, VFA/CSA and albumin (ALB) in both groups between preoperative, 3, and 12 months after surgery. The loss of visceral fat in the PRPD group was more prominent than that in the PPPD group at 3 months and 12 months after surgery (p < 0.05). VFA/CSA was higher in the PPPD group than in the PRPD group (3 months: p < 0.05, 12 months: p < 0.001). The proportion of sarcopenic patients increased significantly over time in the PPPD and PRPD groups (p < 0.001). Conclusions Postoperative CSA and VFA continued to significantly decrease in both PPPD and PRPD groups, while the incidence of sarcopenia continued to increase. Compared with PRPD, PPPD has a protective effect on visceral fat. PPPD may contribute to better maintaining visceral fat mass and blood ALB levels. CT quantification can be an objective and effective method to evaluate the nutritional status of pancreatic cancer patients during the pre‐ and postoperative period and can provide a useful objective basis for guiding clinical treatment.
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spelling doaj-art-e9a0500437b140ee9f4fcf282452fc102025-08-20T01:53:22ZengWileyCancer Medicine2045-76342023-02-011232713272110.1002/cam4.5155Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomyQianna Jin0Qianqian Ren1Xiaona Chang2Xiaoming Lu3Guobin Wang4Nan He5Department of Radiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaDepartment of Radiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaDepartment of Pathology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaDepartment of Gastrointestinal Surgery, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaAbstract Objectives To investigate if different methods of pancreatoduodenectomy (with or without pyloric preservation) would have different impacts on postoperative nutrition and body composition changes among pancreatic cancer patients. Methods Demographic and clinicopathological data, perioperative data were collected, body composition (e.g. skeletal muscle cross‐sectional area [CSA], visceral fat area [VFA]) were evaluated with abdominal CT before and after surgery. Sarcopenia patients' proportion changes were also recorded. Results The hospital stay in the PRPD group was significantly less than that in the PPPD group (p < 0.05). A significant difference was found in CSA, skeletal muscle index (SMI), VFA, VFA/CSA and albumin (ALB) in both groups between preoperative, 3, and 12 months after surgery. The loss of visceral fat in the PRPD group was more prominent than that in the PPPD group at 3 months and 12 months after surgery (p < 0.05). VFA/CSA was higher in the PPPD group than in the PRPD group (3 months: p < 0.05, 12 months: p < 0.001). The proportion of sarcopenic patients increased significantly over time in the PPPD and PRPD groups (p < 0.001). Conclusions Postoperative CSA and VFA continued to significantly decrease in both PPPD and PRPD groups, while the incidence of sarcopenia continued to increase. Compared with PRPD, PPPD has a protective effect on visceral fat. PPPD may contribute to better maintaining visceral fat mass and blood ALB levels. CT quantification can be an objective and effective method to evaluate the nutritional status of pancreatic cancer patients during the pre‐ and postoperative period and can provide a useful objective basis for guiding clinical treatment.https://doi.org/10.1002/cam4.5155body compositionCTpancreatoduodenectomypylorus‐resecting pancreatoduodenectomysarcopenia
spellingShingle Qianna Jin
Qianqian Ren
Xiaona Chang
Xiaoming Lu
Guobin Wang
Nan He
Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy
Cancer Medicine
body composition
CT
pancreatoduodenectomy
pylorus‐resecting pancreatoduodenectomy
sarcopenia
title Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy
title_full Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy
title_fullStr Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy
title_full_unstemmed Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy
title_short Pylorus‐preserving versus Pylorus‐resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy
title_sort pylorus preserving versus pylorus resecting impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy
topic body composition
CT
pancreatoduodenectomy
pylorus‐resecting pancreatoduodenectomy
sarcopenia
url https://doi.org/10.1002/cam4.5155
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AT qianqianren pyloruspreservingversuspylorusresectingimpactondynamicchangesofnutritionandbodycompositioninpancreaticcancerpatientsbeforeandafterpancreatoduodenectomy
AT xiaonachang pyloruspreservingversuspylorusresectingimpactondynamicchangesofnutritionandbodycompositioninpancreaticcancerpatientsbeforeandafterpancreatoduodenectomy
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