Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지

Pancreatic Diabetes after Distal Pancreatectomy: Incidence Rate and Risk Factors

  • Kim, Ka-Jeong (Department of Surgery, Gyeongsang National University Hospital) ;
  • Jeong, Chi-Young (Department of Surgery, Gyeongsang National University Hospital) ;
  • Jeong, Sang-Ho (Department of Surgery, Gyeongsang National University Hospital) ;
  • Ju, Young-Tae (Department of Surgery, Gyeongsang National University Hospital) ;
  • Jung, Eun-Jung (Department of Surgery, Gyeongsang National University Hospital) ;
  • Lee, Young-Joon (Department of Surgery, Gyeongsang National University Hospital) ;
  • Choi, Sang-Kyung (Department of Surgery, Gyeongsang National University Hospital) ;
  • Ha, Woo-Song (Department of Surgery, Gyeongsang National University Hospital) ;
  • Park, Soon-Tae (Department of Surgery, Gyeongsang National University Hospital) ;
  • Hong, Soon-Chan (Department of Surgery, Gyeongsang National University Hospital)
  • Published : 2011.05.30
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Abstract

Purpose: Pancreatectomy can impair production of endocrine and exocrine hormones. In this study, we evaluated: 1) the incidence rate of diabetes in patients undergoing distal pancreatectomy; 2) the correlation between the occurrence of pancreatic diabetes and the extent of the resected pancreas; and 3) factors associated with the development of pancreatic diabetes. Methods: We retrospectively reviewed the cases of 26 patients who could be compared in abdominal computed tomography before and after distal pancreatectomy for benign or malignant lesions between January, 1999 to June, 2010. Results: The incidence of pancreatic diabetes was 19.2%. Obese patients (BMI>25.0 kg/$m^{2}$) had a higher incidence (p=0.029) of pancreatic diabetes after distal pancreatectomy than non-obese patients. The diabetes group had larger volumes of resected pancreas, but the difference was not statistically significant (p=0.105). Conclusion: Several factors may be associated with the development of pancreatic diabetes after distal pancreatectomy. It is necessary to closely follow-up development of pancreatic diabetes regardless of the extent of resection.

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References

  1. Slezak LA, Andersen DK. Pancreatic resection: effects on glucose metabolism. World J Surg 2001;25:452-460. https://doi.org/10.1007/s002680020337
  2. Hutchins RR, Hart RS, Pacifico M, Bradley NJ, Williamson RC. Long-term results of distal pancreatectomy for chronic pancreatitis in 90 patients. Ann Surg 2002;236:612-618. https://doi.org/10.1097/00000658-200211000-00011
  3. Berney T, Rudisuhli T, Oberholzer J, Caulfield A, Morel P. Long-term metabolic results after pancreatic resection for severe chronic pancreatitis. Arch Surg 2000;135:1106-1111. https://doi.org/10.1001/archsurg.135.9.1106
  4. Huang JJ, Yeo CJ, Sohn TA, et al. Quality of life and outcomes after pancreaticoduodenectomy. Ann Surg 2000;231:890-898. https://doi.org/10.1097/00000658-200006000-00014
  5. Lemaire E, O'Toole D, Sauvanet A, Hammel P, Belghiti J, Ruszniewski P. Functional and morphological changes in the pancreatic remnant following pancreaticoduodenectomy with pancreaticogastric anastomosis. Br J Surg 2000;87:434-438. https://doi.org/10.1046/j.1365-2168.2000.01388.x
  6. Andersen HB, Baden H, Brahe NE, Burcharth F. Pancreaticoduodenectomy for periampullary adenocarcinoma. J Am Coll Surg 1994;179:545-552.
  7. Lillemoe KD, Kaushal S, Cameron JL, Sohn TA, Pitt HA, Yeo CJ. Distal pancreatectomy: indications and outcomes in 235 patients. Ann Surg 1999;229:693-698. https://doi.org/10.1097/00000658-199905000-00012
  8. Kahl S, Malfertheiner P. Exocrine and endocrine pancreatic insufficiency after pancreatic surgery. Best Pract Res Clin Gastroenterol 2004;18:947-955. https://doi.org/10.1016/S1521-6918(04)00089-7
  9. Lee BW, Kang HW, Heo JS, et al. Insulin secretory defect plays a major role in the development of diabetes in patients with distal pancreatectomy. Metabolism 2006;55:135-141. https://doi.org/10.1016/j.metabol.2005.08.005
  10. King J, Kazanjian K, Matsumoto J, et al. Distal pancreatectomy: incidence of postoperative diabetes. J Gastrointest Surg 2008;12:1548-1553. https://doi.org/10.1007/s11605-008-0560-5
  11. Roggin KK, Rudloff U, Blumgart LH, Brennan MF. Central pancreatectomy revisited. J Gastrointest Surg 2006;10:804-812. https://doi.org/10.1016/j.gassur.2005.11.012
  12. Ishikawa O, Ohigashi H, Eguchi H, et al. Long-term follow-up of glucose tolerance function after pancreaticoduodenectomy: comparison between pancreaticogastrostomy and pancreaticojejunostomy. Surgery 2004;136:617-623. https://doi.org/10.1016/j.surg.2004.01.006
  13. Falconi M, Mantovani W, Crippa S, Mascetta G, Salvia R, Pederzoli P. Pancreatic insufficiency after different resections for benign tumours. Br J Surg 2008;95:85-91.
  14. Najarian JS, Sutherland DE, Baumgartner D, et al. Total or near total pancreatectomy and islet autotransplantation for treatment of chronic pancreatitis. Ann Surg 1980;192:526-542. https://doi.org/10.1097/00000658-198010000-00011