Body composition and physical function in postoperative pancreatic cancer: pancreatoduodenectomy versus distal pancreatectomy.

[OBJECTIVE] The purpose of this study was to investigate the postoperative course of pancreatoduodenectomy (PD) and distal pancreatectomy (DP) by examining body composition, physical function, physical activity and total intake to 1 month postoperatively, and to compare the two groups.

[STUDY DESIGN] This study is a retrospective observational study investigating.

[METHODS] Forty-nine patients for whom preoperative and postoperative evaluation was possible were included. Measurements included operative time, intraoperative blood loss, body weight, body fat mass, skeletal muscle mass index (SMI), grip strength, lower limb muscle strength, walking speed, physical activity, oral intake, total intake, sarcopenia and complications. Body weight, body fat mass, SMI, grip strength, muscle strength of the lower limb, walking speed and sarcopenia were measured preoperatively and 1 month postoperatively.

[RESULTS] Weight, SMI, body fat mass and grip strength were significantly lower in both groups at 1 month postoperatively compared with preoperatively (p<0.05). The per cent change in body weight, SMI, body fat mass and grip strength between preoperative and 1 month postoperatively for each group was all significantly lower for PD compared with DP (p<0.05). Postoperative activity and oral intake were significantly lower in the PD group compared with the DP group (p<0.05). The incidence of sarcopenia increased significantly in PD at 1 month postoperatively (p<0.05).

[CONCLUSIONS] The present study suggests that PD is associated with lower postoperative body composition, physical function and activity than DP. Rehabilitation intervention that takes into account postoperative physical function, physical activity and nutritional status is required, especially for the PD group.