Division of Trauma Surgery and Critical Care, Department of Surgical Disciplines, JPN Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, 29, India.
Department of Endocrinology, Diabetes & Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Eur J Trauma Emerg Surg. 2022 Feb;48(1):97-105. doi: 10.1007/s00068-021-01638-8. Epub 2021 Mar 14.
Injury to the pancreas may lead to significant morbidity and mortality. We aim to assess pancreatic endocrine and exocrine functions and evaluated morphological regenerations of pancreas following partial pancreatectomy in patients with pancreatic trauma.
The study was performed between June 2016 and December 2017. Endocrine functions were assessed at the time of admission and at 6 months follow-up with 75 g oral glucose tolerance test (OGTT), serum insulin and C-peptide levels and HbA1c estimation and exocrine functions were assessed with fecal elastase test. Pancreatic volumetry was done with imaging scan at 1 month and 6 months post discharge.
Twenty patients were studied with a median age of 30 years (range18-48) at the time of injury. All the patients were normoglycemic on admission; only one patient who underwent pancreatic resection developed diabetes mellitus at follow-up. Eight patients (40%) were found to be prediabetic by American Diabetes Association (ADA) criteria. Eleven patients (55%) had pancreatic exocrine insufficiency. Pancreatic volume increment, from the mean pancreatic volume of 48.65 to 54.29 cm, was noted in patients who underwent partial pancreatectomy.
Patients with pancreatic trauma may develop biochemical endocrine and exocrine insufficiencies following pancreatic resection. Pancreatic volume increment requires further research in a larger study.
胰腺损伤可能导致严重的发病率和死亡率。我们旨在评估胰腺外伤患者行胰腺部分切除术后的胰腺内分泌和外分泌功能以及胰腺形态学再生情况。
本研究于 2016 年 6 月至 2017 年 12 月进行。入院时和 6 个月随访时进行内分泌功能评估，采用 75g 口服葡萄糖耐量试验（OGTT）、血清胰岛素和 C 肽水平以及 HbA1c 评估，粪便弹性蛋白酶试验评估外分泌功能。出院后 1 个月和 6 个月行影像学扫描行胰腺容积测定。
共 20 例患者入组，损伤时的中位年龄为 30 岁（18-48 岁）。所有患者入院时血糖正常，仅 1 例接受胰腺切除术的患者在随访时发生糖尿病。8 例（40%）患者按美国糖尿病协会（ADA）标准被诊断为糖尿病前期。11 例（55%）患者存在胰腺外分泌功能不全。行胰腺部分切除术的患者胰腺体积从平均 48.65cm3 增加至 54.29cm3。
胰腺外伤患者行胰腺切除术后可能出现生化内分泌和外分泌不足。胰腺体积增加需要在更大的研究中进一步研究。
