Predicting new-onset diabetes after minimally invasive subtotal distal pancreatectomy in benign and borderline malignant lesions of the pancreas

Ho Kyoung Hwang, Jiae Park, Sung Hoon Choi, Chang Moo Kang, Woo Jung Lee, Ho Kyoung Hwang, Jiae Park, Sung Hoon Choi, Chang Moo Kang, Woo Jung Lee

Abstract

The purpose of this study was to evaluate the time-dependent probability and risk factors of pancreatogenic diabetes mellitus (PDM) in patients who underwent minimally invasive subtotal distal pancreatectomy.Changes in glucose metabolic consequence of 34 patients (laparoscopic: 31, robotic: 3) who underwent surgery from December 2005 to December 2014 were estimated by assessing impaired fasting glucose, PDM, and PDM-free time analysis.A total of 22 patients showed glucose intolerance, including 13 (38.2%) with impaired fasting glucose and 9 (26.5%) with PDM. The median onset time of PDM was 6.8 months (range 5.3-13.2 months). The PDM-free time probability according to time interval was 94.1% (6 months), 75.9% (12 months), and 72.6% (18 months). It was shown that body mass index>23 kg/m (49.9 vs 87.9 months, P = .020) and preoperative cholesterol >200 mg/dL (40.9 vs 85.2 months, P = .003) adversely influenced PDM-free time. Preoperative cholesterol >200 mg/dL (hazard ratio = 6.172; 95% confidence interval, 1.532-24.865; P = .010) was significantly associated with short PDM-free time in Cox proportional hazards model.Patients with high cholesterol levels and high BMI should be closely monitored for the development of PDM.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Figures

Figure 1
Figure 1
PDM-free time rate after MI-STDP. PDM-free time rates according to time interval after surgery were 94.1% (6 months), 75.9% (12 months), and 72.6% (18 months).
Figure 2
Figure 2
Influence of BMI and cholesterol level on PDM-free time. BMI >23 kg/m2 (49.9 vs 87.9 months, P = .020) and preoperative cholesterol >200 mg/dL (40.9 vs 85.2 months, P = .003) adversely influenced PDM-free time rate during follow-up period.

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Source: PubMed

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