Shen Jiliang, Cao Jiasheng, He Jie, Yu Hong, Chen Mingyu
Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang Province, China.
Department of Radiology, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang Province, China.
Heliyon. 2023 May 3;9(5):e15998. doi: 10.1016/j.heliyon.2023.e15998. eCollection 2023 May.
Limited literature is available on new-onset diabetes mellitus (NODM) after distal pancreatectomy. This study aimed to investigate the correlation between surgery-related factors and the incidence of NODM after distal pancreatectomy.
Patients were divided into the NODM-positive or NODM-negative group according to the diagnosis of NODM. After propensity score matching, the correlation between operation-related factors and the incidence of NODM was analyzed. The diagnostic threshold for predicting NODM was determined using the receiver operating characteristic (ROC) curve and the Youden index.
No significant correlation was observed between the NODM incidence after distal pancreatectomy and operative blood loss, spleen preservation, surgical method (open or laparoscopy), postoperative ALB and HB (first day after surgery), and postoperative pathology. However, a significant correlation was found between the NODM incidence and the postoperative pancreatic volume or the resected pancreatic volume ratio. Resected pancreatic volume ratio was identified as a predictive risk factor for NODM. Youden index of the ROC curve was 0.548, with a cut off value of 32.05% for resected pancreatic volume ratio. The sensitivity and specificity of the cut off values were 0.952 and 0.595, respectively.
This study demonstrated that the volume ratio of pancreatic resection is a risk factor for the incidence of NODM after distal pancreatectomy. This can be used to predict the incidence of NODM and may have further clinical applications.
关于胰体尾切除术后新发糖尿病（NODM）的文献有限。本研究旨在探讨手术相关因素与胰体尾切除术后NODM发生率之间的相关性。
根据NODM的诊断将患者分为NODM阳性组或NODM阴性组。在倾向评分匹配后，分析手术相关因素与NODM发生率之间的相关性。使用受试者工作特征（ROC）曲线和尤登指数确定预测NODM的诊断阈值。
胰体尾切除术后NODM发生率与术中失血、脾脏保留、手术方式（开放或腹腔镜）、术后白蛋白和血红蛋白（术后第一天）以及术后病理之间未观察到显著相关性。然而，发现NODM发生率与术后胰腺体积或切除胰腺体积比之间存在显著相关性。切除胰腺体积比被确定为NODM的预测危险因素。ROC曲线的尤登指数为0.548，切除胰腺体积比的截断值为32.05%。截断值的敏感性和特异性分别为0.952和0.595。
本研究表明，胰腺切除体积比是胰体尾切除术后NODM发生率的危险因素。这可用于预测NODM的发生率，并可能有进一步的临床应用。
