Background : We can quantitatively estimate vertebral bone density by measuring Hounsfield (HU) units on CT images. Recently, it has been reported that reduction of vertebral bone density is associated with postoperative complications and oncologic outcomes. The aim of this study is to investigate clinical significances of vertebral bone density after pancreaticoduodenectomy (PD) for pancreas cancer.

Methods : We retrospectively identified 93 patients who underwent PD for pancreatic cancer from January 2000 to December 2016. Three mortality cases (3.2%) and 7 follow-up loss cases were excluded, and 83 patients were included in this study. We reviewed the preoperative clinical data, postoperative complications, and oncologic outcomes. On an axial CT section at the mid-L2-5 level, we obtained the mean HU of the trabecular bone of the vertebral body. We investigated the postoperative changes of the index and clinical outcomes.

Results : The median follow-up time was 22 months (range, 3.0 to 153.0). The mean preoperative HU value was 142.9 (?52.5), and the mean postoperative HU value was 137.4. (?52.1). The HU value was decreased on postoperative 6 months and 1 year (136.8 ?50.3 and 129.5 ?44.5, respectively). The reduction of vertebral HU value was statistically associated with age, gender, hypertension, and diabetes. However, there was not statistically significance for postoperative complication and survival outcomes in multivariate analysis.

Conclusions : The average HU value of vertebral bone was decreased after PD for pancreas cancer. Although there were not statistical significances in this study, pancreatic surgery often causes nutritional imbalances that associated with poor outcome. This study has a small number of cases compared to the variable to be analyzed. Therefore, further large-scale study is necessary.