Acute Postoperative Changes in Body Composition and Muscle Function Among Patients with Pancreatic Cancer Undergoing Pancreaticoduodenectomy

Abstract

Aim: To observe changes in the nutritional status of patients during the acute postoperative
days following pancreaticoduodenectomy and to evaluate their influence on
postoperative complications.
Methods: Nutritional status was assessed in 72 patients on the preoperative day before
surgery and postoperative days (PD) 3 and 8, included measurements of body
composition by bioimpedance impedance analysis, biochemical values and muscle
function by maximum handgrip strength (HGS). The presence of postoperative complications
was collected over 30 post operative days. Changes at PD were calculated
for all variables. Non-parametric statistics were used and results are given as median
(25th–75th quartiles).
Results : Significant changes occurred on PD 3 in body weight +2.3 (0.8–3.6) kg, total
body water +2.8 (1.1–5.9) l, extracellular water +2.5 (1.2–3.7) l, intracellular water
+1.1 (-0.4–1.9) l, phase angle -1.0 (-1.2 to -0.7)°, C-reactive protein +58.0 (36.0–100.8)
mg/l, serum albumin -12 (-16.5 to -10.0) g/l, and HGS -4.8 (-7.3 to -3.0) kg. Higher but
no significant changes were observed at PD 3 in patients with postoperative complications
(n=28) compared to those without (n=44). The hospital stay was longer in
patients with complications (12.5 days, p=0.005).
Conclusion: Changes in body composition, biochemical values and muscle function
were observed during the first 8 PDs. Changes at PD 3 did not influence significantly
the outcomes, but trends in body fluids and phase angle were found among patients
with postoperative complications.