OBJECTIVES: Glucose homeostasis changes after pancreatic resection are not well understood. We aimed to identify the incidence of, and risk factors for, a change in glucose homeostasis in patients who underwent pancreatectomy for benign pancreatic tumors. METHODS: Clinical and pathological data from 229 patients were collected prospectively and analyzed retrospectively. The pancreas resection volume was calculated by computed tomography volumetry. RESULTS: After pancreatectomy, newly diagnosed diabetes mellitus (DM) occurred in 52 patients (22.7%) and impaired fasting glucose and impaired glucose tolerance occurred in 74 patients (32.3%). The incidence of DM was highest for patients who underwent distal pancreatectomy (DP) (30.5%). Patients in the DP group had a significantly increased rate of DM as the pancreatic resection volume (in milliliters) and resected volume ratio (in percent) increased. A high body mass index and older age were significant risk factors for the development of DM by multivariate analysis. CONCLUSIONS: The resection volume of the pancreas is associated with a change in glucose homeostasis after pancreatectomy. Therefore, preservation of the pancreatic parenchyma is important to minimize the onset of DM in patients with a high pancreatic resected volume ratio (>35.6%) in DP, a high body mass index, or in old age.
OBJECTIVES:Glucose homeostasis changes after pancreatic resection are not well understood. We aimed to identify the incidence of, and risk factors for, a change in glucose homeostasis in patients who underwent pancreatectomy for benign pancreatic tumors. METHODS: Clinical and pathological data from 229 patients were collected prospectively and analyzed retrospectively. The pancreas resection volume was calculated by computed tomography volumetry. RESULTS: After pancreatectomy, newly diagnosed diabetes mellitus (DM) occurred in 52 patients (22.7%) and impaired fasting glucose and impaired glucose tolerance occurred in 74 patients (32.3%). The incidence of DM was highest for patients who underwent distal pancreatectomy (DP) (30.5%). Patients in the DP group had a significantly increased rate of DM as the pancreatic resection volume (in milliliters) and resected volume ratio (in percent) increased. A high body mass index and older age were significant risk factors for the development of DM by multivariate analysis. CONCLUSIONS: The resection volume of the pancreas is associated with a change in glucose homeostasis after pancreatectomy. Therefore, preservation of the pancreatic parenchyma is important to minimize the onset of DM in patients with a high pancreatic resected volume ratio (>35.6%) in DP, a high body mass index, or in old age.
Authors: Jiro Kusakabe; Blaire Anderson; Jingxia Liu; Gregory A Williams; William C Chapman; Majella M B Doyle; Adeel S Khan; Dominic E Sanford; Chet W Hammill; Steven M Strasberg; William G Hawkins; Ryan C Fields Journal: J Gastrointest Surg Date: 2019-01-22 Impact factor: 3.452
Authors: Stephen A Firkins; Phil A Hart; Kyle Porter; ChienWei Chiang; Jordan M Cloyd; Mary Dillhoff; Luis F Lara; Andrei Manilchuk; Georgios I Papachristou; Timothy M Pawlik; Allan Tsung; Darwin L Conwell; Somashekar G Krishna Journal: Pancreas Date: 2022-07-19 Impact factor: 3.243