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Research ArticleClinical Studies

Impact of Abdominal Aortic Calcification After Major Hepatobiliary Pancreatic Surgery: A Retrospective Cohort Study

YUKI IMAOKA, MASAHIRO OHIRA, KOKI SATO, KOUKI IMAOKA, TOMOAKI BEKKI, RYOSUKE NAKANO, SHINTARO KURODA, HIROYUKI TAHARA, KENTARO IDE, TSUYOSHI KOBAYASHI, YUKA TANAKA and HIDEKI OHDAN
Anticancer Research December 2022, 42 (12) 5983-5989; DOI: https://doi.org/10.21873/anticanres.16109
YUKI IMAOKA
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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MASAHIRO OHIRA
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
2Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
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  • For correspondence: mohira@hiroshima-u.ac.jp
KOKI SATO
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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KOUKI IMAOKA
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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TOMOAKI BEKKI
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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RYOSUKE NAKANO
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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SHINTARO KURODA
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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HIROYUKI TAHARA
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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KENTARO IDE
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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TSUYOSHI KOBAYASHI
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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YUKA TANAKA
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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HIDEKI OHDAN
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, Hiroshima, Japan;
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Abstract

Background/Aim: The rate of postoperative morbidity after major hepatobiliary pancreatic (HBP) surgery is estimated to be high. We hypothesized that the frailty and insufficient blood supply of organs caused by arteriosclerosis may lead to increased severity of postoperative complications. The aim of this study was to clarify the relationship between abdominal aortic calcification (AAC) and severity of major HBP surgery postoperative complications. Patients and Methods: A total of 322 major HBP surgeries were performed in Hiroshima University Hospital, Japan from January 2010 to March 2018. The records of 214 patients were retrospectively analyzed to include those with hepatectomy in two or more segments. These included donor hepatectomy, hepatectomy with biliary tract reconstruction, and pancreaticoduodenectomy. We compared the baseline AAC levels (cut-off; 1,000 mm3) with their corresponding levels after HBP surgery complications developed. The complication severity was assessed using the Comprehensive Complication Index (CCI). Results: The high-AAC (N=71) group had significantly increased incidence rates of surgical site infections and a higher CCI, even after propensity matching. Multivariate analysis revealed that a higher AAC was an independent risk factor of severe postoperative complications (CCI ≥40) (OR=10.21, p<0.01). Conclusion: An increased AAC has a corresponding increase in postoperative complication severity after major HBP surgery. Careful anastomosis and infection control are required to prevent the progression of severe postoperative complications among high-AAC patients.

Key Words:
  • Abdominal aortic calcification
  • comprehensive complication index
  • complications
  • HBP surgery
  • risk factors
  • Received September 22, 2022.
  • Revision received October 4, 2022.
  • Accepted October 12, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (12)
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Impact of Abdominal Aortic Calcification After Major Hepatobiliary Pancreatic Surgery: A Retrospective Cohort Study
YUKI IMAOKA, MASAHIRO OHIRA, KOKI SATO, KOUKI IMAOKA, TOMOAKI BEKKI, RYOSUKE NAKANO, SHINTARO KURODA, HIROYUKI TAHARA, KENTARO IDE, TSUYOSHI KOBAYASHI, YUKA TANAKA, HIDEKI OHDAN
Anticancer Research Dec 2022, 42 (12) 5983-5989; DOI: 10.21873/anticanres.16109

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Impact of Abdominal Aortic Calcification After Major Hepatobiliary Pancreatic Surgery: A Retrospective Cohort Study
YUKI IMAOKA, MASAHIRO OHIRA, KOKI SATO, KOUKI IMAOKA, TOMOAKI BEKKI, RYOSUKE NAKANO, SHINTARO KURODA, HIROYUKI TAHARA, KENTARO IDE, TSUYOSHI KOBAYASHI, YUKA TANAKA, HIDEKI OHDAN
Anticancer Research Dec 2022, 42 (12) 5983-5989; DOI: 10.21873/anticanres.16109
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Keywords

  • Abdominal aortic calcification
  • comprehensive complication index
  • complications
  • HBP surgery
  • risk factors
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