Association Between Preoperative Sarcopenia and Postoperative Complications Following Hepatopancreatobiliary Cancer Surgery at a Tertiary Care Center in Eastern India

Background Postoperative morbidity continues to be a significant concern in hepatopancreatobiliary (HPB) cancer surgeries despite advances in surgical and perioperative care. Sarcopenia, defined as the loss of skeletal muscle mass and strength, has emerged as an important predictor of poor surgical outcomes. Limited data from India exist regarding its impact on postoperative complications and infections in HPB cancer patients. This study aimed to evaluate the association between preoperative sarcopenia and postoperative morbidity in patients undergoing HPB cancer surgeries. Methods A prospective observational study was conducted at the Institute of Medical Sciences and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, India, between January 2022 and June 2023. Fifty-three patients aged 18-85 years with operable HPB malignancies were included. Sarcopenia was assessed preoperatively using anthropometric measures (mid-arm circumference and handgrip strength) and computed tomography (CT)-derived skeletal muscle index (SMI) at the L3 vertebral level. The cut-off for sarcopenia was defined as