胰头切除术对慢性胰腺炎患者血糖稳态的影响。
The Impact of Pancreatic Head Resection on Blood Glucose Homeostasis in Patients with Chronic Pancreatitis.
作者信息
Hempel Sebastian, Oehme Florian, Ehehalt Florian, Solimena Michele, Kolbinger Fiona R, Bogner Andreas, Welsch Thilo, Weitz Jürgen, Distler Marius
机构信息
Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany.
Paul Langerhans Institute Dresden, Helmholtz Center Munich, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany.
出版信息
J Clin Med. 2022 Jan 27;11(3):663. doi: 10.3390/jcm11030663.
BACKGROUND
Chronic pancreatitis (CP) often leads to recurrent pain as well as exocrine and/or endocrine pancreatic insufficiency. This study aimed to investigate the effect of pancreatic head resections on glucose metabolism in patients with CP.
METHODS
Patients who underwent pylorus-preserving pancreaticoduodenectomy (PPPD), Whipple procedure (cPD), or duodenum-preserving pancreatic head resection (DPPHR) for CP between January 2011 and December 2020 were retrospectively analyzed with regard to markers of pancreatic endocrine function including steady-state beta cell function (%B), insulin resistance (IR), and insulin sensitivity (%S) according to the updated Homeostasis Model Assessment (HOMA2).
RESULTS
Out of 141 pancreatic resections for CP, 43 cases including 31 PPPD, 2 cPD and 10 DPPHR, met the inclusion criteria. Preoperatively, six patients (14%) were normoglycemic (NG), 10 patients (23.2%) had impaired glucose tolerance (IGT) and 27 patients (62.8%) had diabetes mellitus (DM). In each subgroup, no significant changes were observed for HOMA2-%B (NG: 0.57; IGT: = 0.38; DM: = 0.1), HOMA2-IR (NG: 0.41; IGT: = 0.61; DM: = 0.18) or HOMA2-%S (NG: = 0.44; IGT: = 0.52; DM: = 0.51) 3 and 12 months after surgery, respectively.
CONCLUSION
Pancreatic head resections for CP, including DPPHR and pancreatoduodenectomies, do not significantly affect glucose metabolism within a follow-up period of 12 months.
背景
慢性胰腺炎（CP）常导致反复疼痛以及胰腺外分泌和/或内分泌功能不全。本研究旨在探讨胰头切除术对CP患者糖代谢的影响。
方法
回顾性分析2011年1月至2020年12月期间因CP接受保留幽门胰十二指肠切除术（PPPD）、惠普尔手术（cPD）或保留十二指肠胰头切除术（DPPHR）的患者，根据更新的稳态模型评估（HOMA2）分析胰腺内分泌功能指标，包括稳态β细胞功能（%B）、胰岛素抵抗（IR）和胰岛素敏感性（%S）。
结果
在141例因CP进行的胰腺切除术中，43例符合纳入标准，包括31例PPPD、2例cPD和10例DPPHR。术前，6例患者（14%）血糖正常（NG），10例患者（23.2%）糖耐量受损（IGT），27例患者（62.8%）患有糖尿病（DM）。在每个亚组中，术后3个月和12个月时，HOMA2-%B（NG：0.57；IGT：=0.38；DM：=0.1）、HOMA2-IR（NG：0.41；IGT：=0.61；DM：=0.18）或HOMA2-%S（NG：=0.44；IGT：=0.52；DM：=0.51）均未观察到显著变化。
结论
CP的胰头切除术，包括DPPHR和胰十二指肠切除术，在12个月的随访期内对糖代谢无显著影响。
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