Influence of sarcopenia in major pancreatic surgery. A systematic review of the literature

Gastroenterol Hepatol. 2020 Mar;43(3):142-154. doi: 10.1016/j.gastrohep.2020.01.001. Epub 2020 Feb 20.
[Article in English, Spanish]

Abstract

Post-operative morbidity of pancreatectomies occurs in up to 40-50% of patients, even in modern series. There is a need to find a simple scale in order to identify patients with increased risk of developing major post-operative complications after pancreatic resections. Many studies have been published on sarcopenia and surgical outcomes. Aspects of sarcopenia are presented, along with a systematic review using PRISMA guidelines, in order to search for articles about sarcopenia and pancreatic surgery. The impact of sarcopenia on morbidity and mortality in pancreatic resections is still unclear. The studies presented have been carried out over long periods of time, and many of them compare patients with different diseases. There are also different definitions of sarcopenia, and this can influence the results, as some of the reviewed articles have already shown. It is necessary to unify criteria, both in the definition and in the cut-off values. Prospective studies and consensus on sarcopenia diagnosis should be achieved.

Keywords: Cirugía pancreática; Cáncer de páncreas; Pancreas resection; Pancreatic cancer; Pancreatic surgery; Pancreatoduodenectomy; Pancreatoduodenectomía; Resección pancreática; Sarcopenia.

Publication types

  • Systematic Review

MeSH terms

  • Combined Modality Therapy
  • Dietary Proteins / therapeutic use
  • Exercise Therapy
  • Humans
  • Malnutrition / complications
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / pathology
  • Neoadjuvant Therapy
  • Pancreas Transplantation
  • Pancreatectomy* / mortality
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy* / mortality
  • Pancreatitis, Chronic / complications
  • Pancreatitis, Chronic / surgery
  • Postoperative Complications / etiology*
  • Postoperative Complications / mortality
  • Risk
  • Sarcopenia / complications*
  • Sarcopenia / diagnostic imaging
  • Sarcopenia / pathology
  • Sarcopenia / therapy
  • Tomography, X-Ray Computed

Substances

  • Dietary Proteins