Rumpf K D, Antonschmidt J, Datan C, Zick R, Mitzkat H J
Langenbecks Arch Chir. 1980;351(4):285-92. doi: 10.1007/BF01255810.
Late results were obtained from the follow up of 48 patients with chronic pancreatitis, who underwent partial duodenopancreatectomy. We measured the rest function of the remaining B-cells after resection by daily glucose profile, i.v.-gtt, measurements of the glucagon stimulated C-peptide-output and the amount of C-peptide in the 24-h-urine. In 9% of the cases the operation induced diabetes in addition to the already existing 31%. 3/4 of the nondiabetics showed a latent diabetic metabolism (K value < 1.0). The cause of this, as shown by the C-peptide-analysis, was the loss of the endocrine functional reserve following pancreas resection because of chronic pancreatitis. Therapeutically great differences resulted in reaching and equilibrium of serum glucose in the pancreas resected insulin-dependent patients, because they were dependent on carbohydrates for energy. The tendency to hypoglycaemia represented an additional endangerment.
对48例行部分十二指肠胰腺切除术的慢性胰腺炎患者进行随访，得出远期结果。我们通过每日血糖监测、静脉滴注、胰高血糖素刺激后的C肽分泌量测定以及24小时尿中C肽含量，来测量切除术后剩余B细胞的残余功能。在9%的病例中，手术除了使已有的31%患者患糖尿病外，又诱发了糖尿病。四分之三的非糖尿病患者表现出潜在的糖尿病代谢（K值<1.0）。如C肽分析所示，其原因是慢性胰腺炎导致胰腺切除后内分泌功能储备丧失。在胰腺切除的胰岛素依赖型患者中，治疗上在实现血糖平衡方面存在很大差异，因为他们依赖碳水化合物获取能量。低血糖倾向构成了额外的危险因素。
