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Predictive Factors for Change of Diabetes Mellitus Status After Pancreatectomy in Preoperative Diabetic and Nondiabetic Patients

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

This study aimed to determine risk factors for exacerbation of diabetes mellitus (DM) after pancreatectomy.

Methods

Medical records of 167 patients with benign and malignant pancreaticobiliary diseases who underwent pancreaticoduodenectomy or distal pancreatectomy were retrospectively analyzed. DM was diagnosed by diabetic history or American Diabetes Association criteria. Worsened and improved DM after pancreatectomy was defined when treatment intensity or insulin/oral antidiabetic drug dosage increased or decreased, respectively, postoperatively. Long-standing DM was defined as a duration of >2 years.

Results

In 76 preoperative diabetic patients, worsened and improved DM was observed postoperatively in 46 (60.5 %) and 9 (11.8 %) patients, respectively. In 91 preoperative nondiabetic patients, 22 (24.2 %) developed new-onset DM after pancreatectomy. Multivariate logistic analysis of the preoperative diabetic patients demonstrated long-standing DM and malignancy as independent predictors for postoperative worsened DM. No patients with long-standing DM or insulin treatment experienced improved DM after pancreatectomy. Multivariate logistic analysis of the preoperative nondiabetic patients showed body mass index of ≥25 and hard pancreatic texture as independent risk factors for new-onset postoperative DM.

Conclusions

These results may enable preoperative evaluation of risk factors for worsened or new-onset DM after pancreatectomy and may help plan intensive care for patients at a high risk of postoperative worsened DM.

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Acknowledgments

This investigation has no financial support.

Conflict of Interest

All authors have no conflict of interests.

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Authors and Affiliations

  1. Department of Surgical Oncology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Keiichiro Hirata, Bunzo Nakata, Ryosuke Amano, Sadaaki Yamazoe, Kenjiro Kimura & Kosei Hirakawa

  2. Department of Surgery, Kashiwara Municipal Hospital, Kashiwara City, Osaka, Japan

    Bunzo Nakata

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  1. Keiichiro Hirata
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  2. Bunzo Nakata
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  3. Ryosuke Amano
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  4. Sadaaki Yamazoe
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  5. Kenjiro Kimura
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  6. Kosei Hirakawa
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Correspondence to Bunzo Nakata.

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Hirata, K., Nakata, B., Amano, R. et al. Predictive Factors for Change of Diabetes Mellitus Status After Pancreatectomy in Preoperative Diabetic and Nondiabetic Patients. J Gastrointest Surg 18, 1597–1603 (2014). https://doi.org/10.1007/s11605-014-2521-5

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  • DOI: https://doi.org/10.1007/s11605-014-2521-5

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