ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1576144
This article is part of the Research TopicNutrition in Pancreatic Diseases: The Role of Nutritional Status and Nutrition Therapy in the Management of Pancreatitis and Pancreatic CancerView all 8 articles
Perioperative Evaluation of CT-Based Body Composition as Predictors of Postoperative Outcome
Provisionally accepted
- Research Institute of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China, Nanjing, China
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Although malnutrition is a concern for incremental morbidity in pancreatic surgery, there has been a lack of consensus on nutritional assessment and body composition suitable for prediction of postoperative complications following pancreaticoduodenectomy (PD). Our study was performed to assess whether perioperative CT-based body composition were predictors of morbidity after PD.231 patients who underwent PD between 2020 and 2024 were enrolled to evaluate perioperative body composition. Uni and multivariate logistic regression models were applied to analyze the correlation between major complications, clinically relevant postoperative fistula (CR-POPF) and body composition abnormalities.For 231 patients, the incidence of sarcopenia and visceral obesity was 151 (65.4) and 97 (42.0) .The incidence of complications, major complications and CR-POPF was 68.0%, 33.3% and 10.8%. SMI was the only risk factor for complications (odds ratio [OR], 0.92, 95% confidence interval [CI], 0.85-1.00, p = 0.04). Neither sarcopenia, visceral obesity nor the other body composition had a significant impact on major complications or CR-POPF, while the patients exhibited wide variation in body composition after the surgical trauma. Soft pancreatic texture was the exclusive independent prognostic factor for CR-POPF (OR, 3.23, 95% CI, 1.17-8.89, p = 0.02).Patients with depleted skeletal muscle mass were more likely to develop postoperative complications, while there was no association between perioperative sarcopenia or visceral obesity and major complications or CR-POPF. The study highlights that the highly homogenized and fully managed surgical quality may offset the negative effects of nutritional high-risk factors.
Keywords: Body Composition, Postoperative pancreatic fistula, Pancreaticoduodenectomy, Sarcopenia, Visceral obesity
Received: 13 Feb 2025; Accepted: 09 Jul 2025.
Copyright: © 2025 Cai, Wang, Xie, Zheng, Zhu, Xiao, Wang and Ye. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xinbo Wang, Research Institute of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China, Nanjing, China
Xianghong Ye, Research Institute of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China, Nanjing, China
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