4.6 Article

Preoperative 6-minute walk distance accurately predicts postoperative complications after operations for hepato-pancreato-biliary cancer

Journal

SURGERY
Volume 161, Issue 2, Pages 525-532

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.surg.2016.08.002

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Funding

  1. Ministry of Education, Culture, Sports, and Science and Technology of Japan [16K21081]

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Background. Operation for hepato-pancreato-biliary cancer is among the most invasive open abdominal operations, with a high postoperative morbidity and mortality rate. The purpose of the present study is to investigate whether a preoperative 6-minute walk distance can predict major postoperative complications after operation for hepato-pancreato-biliary diseases. Methods. A total of 81 participants who underwent pancreaticoduodenectomy, major hepatectomy with extrahepatic bile duct resection, or hepatopancreatoduodenectomy were included. The 6-minute walk distance was performed within 1 week before operation. Patients were categorized into 2 groups based on surgical complications: Clavien-Dindo grade < 3 and Clavien-Dindo grade >= 3. Clinical differences between the 2 groups were analyzed. Multivariate logistic regression analysis was performed to identify risk factors for postoperative complications that were categorized as Clavien-Dindo grade >= 3. Results. The multiple logistic regression model revealed a significant correlation between major postoperative complications and preoperative low 6-minute walk distance, low body mass index, and major blood loss. In patients with 6-minute walk distance < 400 m (1,312 feet), the Clavien-Dindo grade was considerably greater than patients with >= 400 m. Conclusion. The 6-minute walk distance is useful in identifying patients with a greater chance of developing major postoperative complications after surgery for hepato-pancreato-biliary cancer.

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