Teshigawara Sanae, Tone Atsuhito, Katayama Akihiro, Imai Yusuke, Tahara Toshihisa, Senoo Mayumi, Watanabe Satoko, Kaneto Mitsuhiro, Shimomura Yasuyuki, Yagi Chiaki, Kajioka Hiroki, Kojima Toru, Niguma Takefumi, Nakatou Tatsuaki
Department of Internal Medicine, Diabetes Center, Okayama Saiseikai General Hospital, 2-25 Kokutaicho, Kita-Ku, Okayama, 700-8511 Japan.
Department of Diabetology and Metabolism, National Hospital Organization, Okayama Medical Center, Okayama, Japan.
Diabetol Int. 2023 Apr 1;14(3):262-270. doi: 10.1007/s13340-023-00623-3. eCollection 2023 Jul.
To investigate changes in insulin requirements over time in patients who underwent hepatectomy and pancreatectomy with perioperative glycemic control by an artificial pancreas (STG-55).
We included 56 patients (22 hepatectomies and 34 pancreatectomies) who were treated with an artificial pancreas in the perioperative period and investigated the differences in insulin requirements by organ and surgical procedure.
The mean intraoperative blood glucose level and total insulin doses were higher in the hepatectomy group than in the pancreatectomy group. The dose of insulin infusion increased in hepatectomy, especially early in surgery, compared to pancreatectomy. In the hepatectomy group, there was a significant correlation between the total intraoperative insulin dose and Pringle time, and in all cases, there was a correlation with surgical time, bleeding volume, preoperative CPR, preoperative TDD, and weight.
Perioperative insulin requirements may be mainly dependent on the surgical procedure, invasiveness, and organ. Preoperative prediction of insulin requirements for each surgical procedure contributes to good perioperative glycemic control and improvement of postoperative outcomes.
研究接受肝切除术和胰腺切除术的患者在围手术期使用人工胰腺（STG - 55）进行血糖控制时胰岛素需求量随时间的变化。
我们纳入了56例患者（22例肝切除术和34例胰腺切除术），这些患者在围手术期接受了人工胰腺治疗，并按器官和手术方式研究了胰岛素需求量的差异。
肝切除术组的术中平均血糖水平和总胰岛素剂量高于胰腺切除术组。与胰腺切除术相比，肝切除术中胰岛素输注剂量增加，尤其是在手术早期。在肝切除术组中，术中总胰岛素剂量与普林格尔时间之间存在显著相关性，并且在所有病例中，与手术时间、出血量、术前心肺复苏、术前每日胰岛素总剂量（TDD）和体重均存在相关性。
围手术期胰岛素需求量可能主要取决于手术方式、侵袭性和器官。对每种手术方式的胰岛素需求量进行术前预测有助于实现良好的围手术期血糖控制并改善术后结局。
