Diabetes Mellitus after Pancreatic Surgery

Abstract

Aim. To highlight the problem of pathogenesis, diagnostics and treatment of diabetes mellitus in the outcome of surgical interventions on the pancreas. Key points. Diabetes mellitus can develop as a result of different diseases, including diseases of the exocrine part of the pancreas. Currently, the term “Diabetes of the Exocrine Pancreas” (DEP) is used. One of the causes of DEP is pancreatic surgery. Pancreatectomy is divided into two main types: total pancreatectomy and partial or pancreatic resection. Partial pancreatectomy, in turn, has two main subtypes: resection of the right half of the pancreas — pancreatoduodenal resection (PDR) and resection of the left half of the pancreas — distal resection (DR). When analyzing the literature data, it is clearly seen that the problem of metabolic outcomes of PDR and others is actively studied and is of great interest. Despite the approximately equal volume of resected tissue, diabetes mellitus occurs more often and earlier after DR, while after PDR, remission of pre-existing diabetes is possible in a significant number of patients. With regard to exocrine function, the situation is reversed — after PDR, the probability of developing exocrine pancreatic insufficiency is higher than after DR. Conclusion. When studying the literature data, it becomes obvious that there is an urgent necessity to develop approaches to the early combination therapy in patients after pancreatic surgery with simultaneous correction of exo- and endocrine pancreatic. Keywords: diabetes mellitus in the outcome of diseases of the exocrine part of the pancreas, pancreas, pancreatectomy, pancreatoduodenal resection of the pancreas, distal resection of the pancreas.