Korean J Hepatobiliary Pancreat Surg.  2012 Nov;16(4):167-171. 10.14701/kjhbps.2012.16.4.167.

Risk factors for pancreatogenic diabetes after pancreaticoduodenectomy

• Oh HM
• Yoon YS
• Han HS
• Kim JH
• Cho JY
• Hwang DW

• KMID: 2243196
• DOI: http://doi.org/10.14701/kjhbps.2012.16.4.167

Abstract

BACKGROUNDS/AIMS
Postoperative diabetes mellitus (DM) after pancreaticoduodenectomy (PD) may compromise the long-term quality of life in survivors after the operative procedure due to the treatment difficulty and its related complications. The aim of this study is to determine the incidence of new-onset pancreatogenic DM after PD and investigate the risk factors for this complication.
METHODS
Among 170 patients who had undergone PD between November 2003 and September 2009, 98 patients were selected for this study. The selected patients were non-diabetic prior to the operation and had undergone follow-up tests for glucose metabolism and an abdominal computed tomography (CT) scan 1 year after the operation. The clinical data of these patients were retrospectively analyzed by reviewing the medical records, radiologic images, and pathologic reports.
RESULTS
Postoperative pathology confirmed malignant tumors in 91 patients, borderline malignancy in 5, and benign tumor in 2. The tumor locations included the pancreatic head (n=30), the common bile duct (CBD) (n=30), ampulla of Vater (n=30), and the duodenum (n=8). New-onset DM occurred in 17 (17.4%) of the 98 patients during the first year after the operation. The comparative analysis between postoperative DM (+) and DM (-) groups revealed that the atrophy of the remaining pancreas was the only significant risk factor for development of postoperative DM after PD.
CONCLUSIONS
This study suggests that the atrophy of the remaining pancreas increases the risk of pancreatogenic DM after PD, and efforts to prevent pancreatic atrophy are needed to decrease this complication.

Keyword

Pancreaticoduodenectomy; Pancreatogenic diatetes mellitus; Pancreatic atrophy

MeSH Terms

Ampulla of Vater
Atrophy
Common Bile Duct
Diabetes Mellitus
Duodenum
Follow-Up Studies
Glucose
Head
Humans
Incidence
Medical Records
Pancreas
Pancreaticoduodenectomy
Quality of Life
Retrospective Studies
Risk Factors
Surgical Procedures, Operative
Survivors
Glucose

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