Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2025; 17(8): 107209
Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.107209
Prevalence of sarcopenia in patients with surgical obstructive jaundice and its impact on clinical outcomes
Run-Nan Zhang, Jian-Yong Cui, Zhong-Hua Zhao, Ya-Tong Li, Zhi-Wei Liu, Ji-Yue Zhang, Qiang Wei, Yan-Min Lu, Qiang-Pu Chen
Run-Nan Zhang, Jian-Yong Cui, Yan-Min Lu, Department of Clinical Nutrition, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
Zhong-Hua Zhao, Ya-Tong Li, Zhi-Wei Liu, Ji-Yue Zhang, Qiang Wei, Qiang-Pu Chen, Department of Hepatobiliary-Pancreatic Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
Co-first authors: Run-Nan Zhang and Jian-Yong Cui.
Author contributions: Zhang RN and Cui JY conducted data curation, methodology, software, validation, writing-original draft and editing; Zhao ZH, Li YT contributed data curation, writing-review and editing; Liu ZW, Zhang JY, Wei Q contributed writing-review and editing; Lu YM contributed writing-review and editing; Chen QP conducted conceptualization, supervision, writing-review and editing. Zhang RN and Cui JY have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper.
Supported by Shandong Province Biliary Pancreatic Cancer Clinical Quality Specialty Construction Fund, No. SLCZDZK-2401.
Institutional review board statement: The research protocol adhered to every provision of the Helsinki Declaration and received approval from the Research Ethics Committee of the Binzhou Medical University Hospital (Approval No. KYLL-264).
Informed consent statement: Since this research project was conducted on the basis of patients' routine treatment surgeries, without any additional procedures and without causing harm to the patients' bodies, we adopted the waiver of informed consent in the clinical setting.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang-Pu Chen, Chief Physician, Professor, Department of Hepatobiliary-Pancreatic Surgery, Binzhou Medical University Hospital, No. 661 Huang He Er Road, Binzhou 256603, Shandong Province, China. drchenqiangpu@163.com
Received: March 18, 2025
Revised: May 31, 2025
Accepted: July 11, 2025
Published online: August 27, 2025
Processing time: 160 Days and 8.2 Hours
Abstract
BACKGROUND

Sarcopenia is a clinical syndrome presented with progressive and generalized skeletal muscle loss and function dysfunction. Usually, it is considered an age-related process influenced by genetic, lifestyle factors, and diseases. Obstructive jaundice is one of the most common pathophysiological changes in patients needing hepatobiliary or pancreatic operations that can adversely affect the tissue and organ function throughout the human body. However, the effects of obstructive jaundice on the occurrence of sarcopenia remain unclear.

AIM

To investigate the incidence of sarcopenia in patients with surgical obstructive jaundice and the association of sarcopenia with postoperative outcome.

METHODS

This cross-sectional study was conducted from December 2019 to January 2024. Data retrieved included patient demographics, disease entities, sarcopenia-related parameters (including grip strength, 6-m walking time, and limb skeletal muscle mass index), postoperative complications, and length of hospital stay. Sarcopenia was confirmed using Asian Working Group standards. Logistic regression was used to analyze the relationship between total bilirubin level and sarcopenia. The factors influencing sarcopenia in patients with surgical obstructive jaundice and association of sarcopenia with postoperative complications were also investigated.

RESULTS

Overall, 1708 patients met the inclusion criteria, with a mean age of 60.09 ± 13.52 years (sex: 52.28% male). There were 383 patients (22.42%) with obstructive jaundice and 1325 (77.58%) without jaundice. Sarcopenia, low walking speed, low grip strength, and low limb skeletal muscle index were more prevalent in patients with obstructive jaundice than nonobstructive jaundice. The odds ratio (OR) for sarcopenia in patients with obstructive jaundice was 1.689 [95% confidence interval (CI): 1.295-2.203, P < 0.001], indicating that jaundice is a significant risk factor for sarcopenia. The occurrence of sarcopenia was higher in patients with severe obstructive jaundice than mild obstructive jaundice (39.3% vs 22.8%, P < 0.05). Obstructive jaundice was positively correlated with reduced walking speed (OR = 1.627, 95%CI: 1.185-2.234, P = 0.003) and decreased grip strength (OR = 1.669, 95%CI: 1.212-2.300, P = 0.002). Age (OR = 1.077, 95%CI: 1.040-1.114, P < 0.001) and body mass index (OR = 0.703, 95%CI: 0.630-0.784, P < 0.001) were independent risk factors of sarcopenia in patients with obstructive jaundice. Patients with obstructive jaundice and sarcopenia had a higher rate of postoperative complications (46.3% vs 33.1%, P = 0.032), longer postoperative hospital stays (11.33 ± 6.75 days vs 9.19 ± 7.32 days, P = 0.016), and longer total hospital stays (17.10 ± 7.69 days vs 15.98 ± 8.55 days, P = 0.032) than those without sarcopenia.

CONCLUSION

Sarcopenia is more prevalent in patients with obstructive jaundice and is positively correlated with the degree of jaundice. Sarcopenia prolongs hospital stays and is associate with postoperative complications.

Keywords: Obstructive jaundice; Sarcopenia; Bilirubin; Length of hospital stay; Postoperative complications

Core Tip: Atrophy of muscles adversely affects surgical treatment and prognosis for patients. As a result, sarcopenia has been receiving increasing attention. The occurrence of sarcopenia associated with hepatobiliary and pancreatic surgical diseases is influenced by various factors. Obstructive jaundice is a common symptom in patients with these diseases; however, few studies have investigated its effects on muscle function. Therefore, this study analyzed obstructive jaundice-related sarcopenia from different perspectives, aiming to provide theoretical support for understanding this condition.