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Long-term changes in body composition after pancreaticoduodenectomy
Article first published online: 19 JAN 2012
DOI: 10.1111/j.1445-2197.2011.05970.x
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons
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How to Cite
Aslani, A., Roach, P. J. and Smith, R. C. (2012), Long-term changes in body composition after pancreaticoduodenectomy. ANZ Journal of Surgery, 82: 173–178. doi: 10.1111/j.1445-2197.2011.05970.x
Publication History
- Issue published online: 2 MAR 2012
- Article first published online: 19 JAN 2012
- Accepted for publication 11 May 2011.
- Abstract
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Keywords:
- body composition;
- fat mass;
- pancreatic neoplasms;
- pancreaticoduodenectomy;
- surgery;
- total body potassium;
- total body protein
Abstract
Background: The Whipple's procedure (WP) is a major operation that adds a further demand on the body's nutritional reserves and therefore body composition after the effect of pancreatic cancer. The aim was to document changes in body composition changes that occur during the first six months after a WP for a pancreatic cancer malignancy.
Methods: Twenty-seven (14 males, 13 females) consecutive WP patients had body composition measured at baseline and then at 2, 5, 14 and 26 weeks after surgery. These included; anthropometric measure (weight, skin folds and arm muscle area (AMA)), total body measures of protein (TBP), potassium (TBK), water (TBW) and fat mass (FM). Changes were compared using repeated measures analysis of variance.
Results: Hospital nutritional care maintained TBP and TBK but at 2 weeks there was a loss of FM (P= 0.037). The nadir of weight loss (P < 0.001) occurred at 5 weeks because of losses of protein (P= 0.007), fat (P < 0.001) and potassium (P= 0.045) but not water. Although weight and FM were still significantly less than baseline measures at 26 weeks weight, TBP, TBK and AMA were not significantly different to preoperative values.
Conclusions: Although at 6 months, important measures of the metabolically functioning tissue, TBP and TBK, have returned to preoperative values significant losses occurred during the first 3 weeks after discharge from hospital and FM did not return to preoperative values. These results suggest the need to improve post-discharge nutritional care.