• 作者：Pablo Parra Membrives ; ^{pabloparra@aecirujanos.es} ; Daniel Dí ; az Gó ; mez ; Darí ; o Martí ; nez Baena ; José ; Manuel Lorente Herce
• 关键词：Control glucé ; mico ; Diabetes ; Duodenopancreatectom&iacute ; a ; Morbilidad
• 刊名：Cirug铆a Espa帽ola
• 出版年：2011
• 期刊代码：pca87_0009739X
• 类别：med
• 出版时间：April 2011
• 卷：89
• 期：4
• 页码：218-222
• 文件大小：236 K

Introduction

Pancreatic resection carries a theoretical risk of developing diabetes; however few studies have demonstrated the effect of a cephalic duodenopancreatectomy on post-operative blood glucose control.

Material and methods

An analysis was made of the post-operative clinical follow up of 70 patients subjected to a cephalic duodenopancreatectomy in our Hospital between March 1993 and November 2009. The surgical indication was due to primary pancreatic disease in 30 patients (21 adenocarcinoma of the pancreas, 6 chronic pancreatitis, 1 endocrine carcinoma, 1 cystadenoma and 1 complicated pseudocyst). The pancreas was not affected in the other 40 patients (24 ampullary carcinomas, 11 cholangiocarcinomas, 3 duodenal carcinomas, 1 papillary adenoma and 1 adenomatous hyperplasia of the bile duct). Data on the pre- and post-operative diabetic state were collected.

Results

Before resection, 49 patients (70.0%) had a normal glucose without the need for treatment. Seventeen patients required oral diabetic treatment, 3 subcutaneous insulin, and only one was treated by diet. The duodenopancreatectomy worsened glucose control in 47.1%of the patients (23 of the previously non-diabetics and 10 of those treated with oral diabetics). Glucose control was worse when the surgical indication was due to primary involvement of the gland (progression of 63.3%) compared with patients with disease (progression of 35.0%) (P < .05).

Conclusions

Our results show that resection of the head of the pancreas favours the appearance of post-operative diabetes, particularly when the surgical indication is due to primary pancreatic involvement.