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Changes in the body composition and nutritional status after total pancreatectomy

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Abstract

Purpose

The purpose of this study was to evaluate changes in the body composition and nutritional status after total pancreatectomy (TP).

Methods

Consecutive 45 patients underwent TP between February 2003 and July 2018. Among them, 32 had computed tomography images available before TP and at 6 and 12 months after TP. The skeletal muscle index (SMI), visceral fat tissue index (VFI), and subcutaneous fat tissue index (SFI) were measured using images at each time. Body mass index (BMI), serum albumin levels (Alb), hemoglobin A1c levels (HbA1c), and daily insulin use were also recorded.

Results

There were significant reductions in SMI (median, 38.7 vs. 36.6 cm2/m2, P = 0.030), VFI (12.4 vs. 5.1 cm2/m2, P < 0.001), SFI (26.5 vs. 9.2 cm2/m2, P < 0.001), BMI (20.3 vs. 18.7 kg/m2, P < 0.001), and Alb (4.2 vs. 3.7 g/dL, P = 0.031) at 6 months after TP compared with preoperative period. HbA1c significantly increased at 6 months after TP compared with postoperative discharge (6.7 vs. 7.3%, P < 0.001). The daily insulin use significantly increased at 12 months after TP compared with 6 months after TP (22 vs. 26 units/day, P < 0.001), whereas there were no significant changes in other parameters.

Conclusions

Significant losses in fat and skeletal muscle mass as well as the BMI and Alb occurred within the first 6 months after TP. A subsequent increase in the daily insulin use occurred during the next six months, which helped preserve the body composition.

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Author information

Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Masao Uemura, Katsuhisa Ohgi, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida & Katsuhiko Uesaka

  2. Division of Interventional Radiology, Shizuoka Cancer Center, Shizuoka, Japan

    Takeshi Aramaki

  3. Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan

    Akifumi Notsu & Takanori Kawabata

Authors
  1. Masao Uemura
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  2. Katsuhisa Ohgi
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  3. Teiichi Sugiura
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  4. Yukiyasu Okamura
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  5. Takaaki Ito
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  6. Yusuke Yamamoto
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  7. Ryo Ashida
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  8. Takeshi Aramaki
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  9. Akifumi Notsu
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  10. Takanori Kawabata
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  11. Katsuhiko Uesaka
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Contributions

Study conception and design: M. Uemura and K. Ohgi. Acquisition of data: M. Uemura, K. Ohgi, T. Sugiura, Y. Okamura, T. Ito, Y. Yamamoto, R. Ashida, T. Aramaki, and K. Uesaka. Analysis and interpretation of data: M. Uemura and K. Ohgi. Drafting of manuscript: M. Uemura. Critical revision of manuscript: K. Ohgi, T. Sugiura, Y. Okamura, T. Ito, Y. Yamamoto, R. Ashida, T. Aramaki, A. Notsu, T. Kawabata, and K. Uesaka. Final approval of the version to be published: all authors.

Corresponding author

Correspondence to Katsuhisa Ohgi.

Ethics declarations

Ethics approval

The study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Research Ethics Committee (J2019-122-2019-1-3).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Uemura, M., Ohgi, K., Sugiura, T. et al. Changes in the body composition and nutritional status after total pancreatectomy. Langenbecks Arch Surg 406, 1909–1916 (2021). https://doi.org/10.1007/s00423-021-02185-x

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  • DOI: https://doi.org/10.1007/s00423-021-02185-x

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