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Diabetes‐related outcomes after pancreatic surgery
Author(s) -
Lee Cynthia Ying Chian,
Depczynski Barbara,
Poynten Ann,
Haghighi Koroush S.
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.16129
Subject(s) - medicine , pancreaticoduodenectomy , pancreatectomy , diabetes mellitus , medical record , complication , surgery , distal pancreatectomy , general surgery , resection , endocrinology
Background The development of pancreatogenic diabetes mellitus (PDM) is a common complication post‐pancreatectomy; however, its prevalence has not been described in Australia. We aimed to describe the glycaemic status pre‐ and post‐pancreatectomy, compare patients' clinical characteristics, group according to pre‐ and post‐pancreatectomy diabetes mellitus (DM) status and identify predictors of post‐operative PDM. Methods We retrospectively reviewed the medical records of patients admitted for pancreatic resection at a single institution from 2011 to 2017. Post‐operative DM status was determined at the time of discharge or at 30 days post‐operation. Longer term DM onset was as documented in medical record subsequent to admission for pancreatic surgery. Results A total of 137 cases were analysed; 13.3% and 24.8% of patients developed post‐operative PDM within 30 days and at median of 1 year (range 1–4 years) follow‐up, respectively. All patients with pre‐existing DM continued to have DM post‐operatively. Patients with pre‐existing DM were older ( P = 0.004) and had a family history of DM ( P = 0.020); 8.3% of patients who had undergone pancreaticoduodenectomy versus 17.1% of patients who had undergone distal pancreatectomy developed PDM ( P = 0.318). A lower estimated glomerular filtration rate ( P = 0.033) was significantly associated with post‐operative PDM development. No independent predictors for post‐operative PDM were identified. Conclusions The new development of DM within 30 days post‐pancreatectomy occurs in approximately one in seven persons. No patients with pre‐existing DM demonstrated a remission of DM post‐pancreatectomy. These findings suggest that all patients should be screened for DM pre‐operatively and followed up post‐operatively, particularly those with pre‐existing impaired renal function.