The Impact of Pancreatic Head Resection on Blood Glucose Homeostasis in Patients with Chronic Pancreatitis

Abstract

Background: Chronic pancreatitis (CP) often leads to recurrent pain as well as exocrine and/or endocrine pancreatic insufficiency. This study aimed to investigate the effect of pancreatic head resections on glucose metabolism in patients with CP. Methods: Patients who underwent pylorus-preserving pancreaticoduodenectomy (PPPD), Whipple procedure (cPD), or duodenum-preserving pancreatic head resection (DPPHR) for CP between January 2011 and December 2020 were retrospectively analyzed with regard to markers of pancreatic endocrine function including steady-state beta cell function (%B), insulin resistance (IR), and insulin sensitivity (%S) according to the updated Homeostasis Model Assessment (HOMA2). Results: Out of 141 pancreatic resections for CP, 43 cases including 31 PPPD, 2 cPD and 10 DPPHR, met the inclusion criteria. Preoperatively, six patients (14%) were normoglycemic (NG), 10 patients (23.2%) had impaired glucose tolerance (IGT) and 27 patients (62.8%) had diabetes mellitus (DM). In each subgroup, no significant changes were observed for HOMA2-%B (NG: p = 0.57; IGT: p = 0.38; DM: p = 0.1), HOMA2-IR (NG: p = 0.41; IGT: p = 0.61; DM: p = 0.18) or HOMA2-%S (NG: p = 0.44; IGT: p = 0.52; DM: p = 0.51) 3 and 12 months after surgery, respectively. Conclusion: Pancreatic head resections for CP, including DPPHR and pancreatoduodenectomies, do not significantly affect glucose metabolism within a follow-up period of 12 months.

Pancreas Imaging of Children with Type 1 Diabetes Reveals New Patterns and Correlations with Pancreatic Functions

“…Endocrine pancreatic cells (e.g., islets number and β-cells area) distribute heterotopically across the pancreas, being mostly located in the pancreas body and tail in the healthy patients [41,42]. Supporting these histological descriptions, the incidence of new-onset diabetes mellitus was higher following a distal pancreatotomy compared to the central or proximal pancreatotomy [54,55] while pancreas head resection did not alter glucose homeostasis at 12 months [55,56]. Evidence in patients with T1D remains more arguable.…”

The Impact of Chronic Pancreatitis on the Occurrences of Human Cancers: Real-World Data

“…Chronic pancreatitis (CP) is a chronic inflammatory disease of the pancreas that could lead to irreversible damage to the pancreatic tissues and to associated exocrine and endocrine insufficiency [1][2][3][4][5]. The diagnosis of CP relies on a combination of image findings that indicate irreversible damage to the pancreas, such as calcification, stones, and duct stricture or dilation, along with manifested exocrine and endocrine dysfunctions [6].…”