Thirty-day outcomes underestimate endocrine and exocrine insufficiency after pancreatic resection

Lim, Pei-Wen; Dinh, Kate H.; Sullivan, Mary; Wassef, Wahid; Živný, J; Whalen, Giles F.; LaFemina, Jennifer

doi:10.1016/j.hpb.2015.11.003

Cited by 64 publications

(42 citation statements)

References 29 publications

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“…Multivariate analysis conducted by Kwon et al in a study population of 225 patients found that patients who were obese (BMI ≥ 25) had increased risk of developing DM post pancreatectomy (OR 1.25; (95% CI: 1.09‐1.43; P = .001). No significant differences were found in the incidence of obesity between DM and non‐DM groups in the remaining studies that assessed for this …”

Section: Resultsmentioning

confidence: 82%

“…Although Wu et al found that of the 3914 patients who did not have pre‐existing diabetes, those with chronic pancreatitis had a significantly higher risk of postoperative DM after multivariate analysis ( P = .001), in five other studies the preoperative pancreatic diagnosis was not predictive of postoperative diabetes risk …”

Section: Resultsmentioning

confidence: 95%

“…Kang et al found that females more likely to develop postoperative DM (OR 5.8; 95% CI: 1.78‐18.91, P = .003) whereas other studies have not found an effect of gender on DM risk …”

Section: Resultsmentioning

confidence: 96%

“…Sample sizes in individual studies ranged from 20 to 4775 patients, with a total of 9970 patients included for analysis. Table summarizes the study characteristics and key results for the included studies . These studies included 5636 patients undergoing pancreaticoduodenectomy, 3922 patients with distal pancreatectomy and 315 undergoing central pancreatectomy.…”

Section: Resultsmentioning

confidence: 99%

“…Forest plot of studies indicating incidence of new‐onset DM after each type of resection. A, Pancreaticoduodenectomy . Random effects model.…”

Section: Resultsmentioning

confidence: 99%

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Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Nahm

Jamieson

et al. 2020

Clinical Endocrinology

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Objectives: Type 3c diabetes mellitus (T3cDM) occurring post pancreatectomy can be challenging to treat due to the frequent combination of decreased circulating levels of insulin and glucagon and concurrent exocrine insufficiency. Relatively, little is known regarding the risk factors for development of T3cDM post pancreatectomy. Our aim was to review the literature and assess what is known of the risk factors for the development of new-onset DM following partial pancreatic resection and where possible determines the incidence, time of onset and the management approach to hyperglycaemia in this context. Design: Medline and Embase databases were reviewed using specific keyword criteria. Original manuscripts published in 1990 or later included. Articles with study population <20, lacking information on new-onset DM, follow-up duration or specifically targeting rare procedures/pathology were excluded. The Newcastle Ottawa Quality Assessment form was applied. Results reported according to PRISMA guidelines. Pooled effect size calculated using random effects model. Patients: Thirty six articles were identified that described a total of 5636 patients undergoing pancreaticoduodenectomy, 3922 patients having distal pancreatectomy and 315 with central pancreatectomy.Results: The incidence of new-onset DM was significantly different between different types of resection from 9% to 24% after pancreaticoduodenectomy (pooled estimate 16%; 95% CI: 14%-17%), 3%-40% after distal pancreatectomy (pooled estimate 21%; 95% CI: 16%-25%) and 0%-14% after central pancreatectomy (pooled estimate 6%; 95% CI: 3%-9%). Surgical site, higher preoperative HbA1c, fasting plasma glucose and lower remnant pancreatic volume had strongest associations with new-onset DM.Conclusions: This systematic review supports that risk of development of T3cDM is associated with type of pancreatic resection, lower remnant pancreatic volume and higher preoperative HbA1c. K E Y W O R D Sdiabetes mellitus, pancreatectomy, pancreatic insufficiency, pancreaticoduodenectomy, Whipple's procedure | 397 WU et al.

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Section: Resultsmentioning

confidence: 82%

Section: Resultsmentioning

confidence: 95%

“…Kang et al found that females more likely to develop postoperative DM (OR 5.8; 95% CI: 1.78‐18.91, P = .003) whereas other studies have not found an effect of gender on DM risk …”

Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

“…Forest plot of studies indicating incidence of new‐onset DM after each type of resection. A, Pancreaticoduodenectomy . Random effects model.…”

Section: Resultsmentioning

confidence: 99%

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