Bak M
Pol Arch Med Wewn. 1989 Mar;81(3):137-43.
Followed were 11 patients after total pancreatectomy (for carcinoma--6 patients, for sequelae of the chronic pancreatitis--5 patients), aged 52-62 years. The follow-up period ranged 5 months up to 4 years. All pacreatomized patients had diabetes needing insulin administration, although the need for insulin decreased with time down to 16-40 units/24 hours after one year. The diabetes was rather brittle with high incidence of hypoglycaemia. In 7 patients keeping exact records the incidence of hypoglycaemic events was 16-24 within the first month, 9-16 in the third month following pancreatectomy. In two patients death was due to the severe hypoglycaemia developing in the later postoperative period. The observations call for a necessary "intensive metabolic care" of every patient, totally pancreatomised. This intensive metabolic care must include not only careful instructing the patients but also his or her family how to behave in a totally different metabolic condition of the patient. Self-control, including blood sugar estimation several times a day gets special importance.
接下来是11例全胰切除术后的患者（6例因癌症，5例因慢性胰腺炎后遗症），年龄在52至62岁之间。随访时间为5个月至4年。所有接受胰腺切除的患者均患有糖尿病，需要注射胰岛素，尽管随着时间推移，胰岛素需求量在一年后降至16至40单位/24小时。糖尿病病情相当不稳定，低血糖发生率较高。在7例详细记录的患者中，低血糖事件的发生率在全胰切除术后第一个月为16至24次，第三个月为9至16次。两名患者死于术后晚期发生的严重低血糖。这些观察结果表明，对于每一位接受全胰切除的患者，都需要进行必要的“强化代谢护理”。这种强化代谢护理不仅必须包括仔细指导患者及其家人如何在患者完全不同的代谢状况下应对，自我监测，包括每天多次进行血糖测定，具有特别重要的意义。
