Relationship Between Remnant Pancreatic Volume and Endocrine Function After Pancreaticoduodenectomy

• Published in: The American surgeon Vol. 88; no. 2; p. 233
• Main Authors: Yamazaki, Tatsuya, Aoki, Takeshi, Tashiro, Yoshihiko, Koizumi, Tomotake, Kusano, Tomokazu, Matsuda, Kazuhiro, Fujimori, Akira, Yamada, Kosuke, Nogaki, Koji, Hakozaki, Tomoki, Wada, Yusuke, Shibata, Hideki, Tomioka, Kodai, Enami, Yuta, Murakami, Masahiko
• Format: Journal Article
• Language: English
• Published: United States 01-02-2022
• Subjects: Aged; C-Peptide - analysis; Diabetes Mellitus - etiology; Female; Humans; Insulin - metabolism; Male; Multidetector Computed Tomography; Organ Size; Pancreas - anatomy & histology; Pancreas - diagnostic imaging; Pancreas - metabolism; Pancreas - surgery; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy - adverse effects; Postoperative Complications - etiology; Postoperative Period; Preoperative Period; Retrospective Studies; diabetes mellitus; C-peptide index; insulin secretion; pancreaticoduodenectomy; pancreatic volume
• ISSN: 1555-9823
• DOI: 10.1177/0003134821989049

Decreased pancreatic volume (PV) is a predictive factor for diabetes mellitus (DM) after surgery. There are few reports on PV and endocrine function pre- and post-surgery. We investigated the correlation between PV and insulin secretion.
Seventeen patients underwent pancreaticoduodenectomy (PD) Pre- and post-surgery PV and C-peptide index (CPI) measurements were performed. Additionally, the correlation between PV and CPI was analyzed.
The mean preoperative PV (PPV) was 55.1 ± 31.6 mL, postoperative remnant PV (RPV) was 25.3±17.3 mL, and PV reduction was 53%. The mean preoperative C-peptide immunoreactivity (CPR) was 1.39 ± .51 and postoperative CPR was .85±.51. The mean preoperative CPI was 1.29±.72 and postoperative CPI was .73 ± .48. Significant correlations were observed between RPV and post CPR (ρ = .507, P = .03) and post CPI (ρ = .619, P = .008).
There was a significant correlation between RPV and CPI after PD. A smaller RPV resulted in lower insulin secretion ability, increasing the potential risk of new-onset DM after PD.