Body composition, muscle function and psychological changes in patients undergoing operation for hepatic or pancreatic disease.
BACKGROUND
There is currently a dearth of data with respect to changes in body composition, physiological function and pSychological state in patients undergoing operative treatment for pancreatic or hepatic disease although marked changes in these variables have been reported in colorectal surgical patients.


METHODS
In 36 patients (37 operations) we have studied the effect of a pancreatic or hepatic operation (with and without nutritional support) on body fat and body protein (assessed by Dual energy X-ray absorptiometry (DEXA) and anthropometry), respiratory function (measured by spirometry and vitalography), voluntary muscle function (measured by hand dynamometry) and psychological state (measured by use of the hospital anxiety and depression score and visual analogue scale for fatigue) over a 1-week period postoperatively.


RESULTS
On the 3rd postoperative day there were significant changes in: grip strength 307 (135-499) to 249 (85-461) N; FEV1 2.28 (0.48-3.98) to 1.02 (0-2.42) litres/min; FVC 2.90 (0.75-5.02) to 1.28 (0.22-3.31) litres; anxiety score 7 (0-17) to 6 (1-20); depression score 3 (0-10) to 5 (0-20), and fatigue 3.9 (0.4-10) to 6.8 (1.0-9.7). These persisted on day 7 by which time mid-arm circumference and total body fat (by DEXA) had fallen from 30.1 (21.1-45.0) to 29.5 (20.2-43.2) cm, and 20.7 (5.8-53.7) to 20.4 (6.6-53.5) kg, respectively.


CONCLUSIONS
We conclude that operative treatment for pancreatic or hepatic disease has an adverse effect on body composition, physiological function and psychological state.
University Department of Surgery, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
R
R
Gupta
R
R
Thurairaja
C D
CD
Johnson
J N
JN
Primrose
D000273:Adipose Tissue / Q000033:anatomy & histology; D000293:Adolescent; D000328:Adult; D001007:Anxiety; D001823:Body Composition / Q000502:physiology*; D003863:Depression; D005260:Female; D018737:Hand Strength; D006801:Humans; D008107:Liver Diseases / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009747:Nutritional Physiological Phenomena; D010182:Pancreatic Diseases / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D010865:Pilot Projects; D011182:Postoperative Care; D012129:Respiratory Function Tests; D012885:Skinfold Thickness