摘要
In the last decade,many investigators including us have reported the negative impact of preoperative sarcopenia or low skeletal muscle mass on outcomes after surgery including hepato-biliary-pancreatic(HBP)surgery such as liver transplantation,liver surgery,biliary surgery,and pancreatic surgery(1-5).In addition to low skeletal muscle mass,the abnormality of body compositions,decreased muscle quality and visceral obesity,has been clarified to be also negatively associated with poor outcomes after HBP surgery(2-5).Consequently,it was easily supposed that co-existence of sarcopenia and obesity,called sarcopenic obesity(SO),had more strong negative impact on outcomes.Actually,not a few studies have demonstrated negative clinical impact of SO on outcomes after HBP surgery using various definitions for SO(6-10).We reported that patients with SO,defined by low skeletal muscle mass with high visceral fat to subcutaneous fat ratio evaluated by preoperative computed tomography(CT)image,had significant worse survival than non-sarcopenia patients and patients with sarcopenia only after liver transplantation,hepatic resection,and pancreatic resection(6-9).
