Relationship between pancreatic parenchyma loss and early postoperative hyperglycemia in patients with benign pancreatic diseases

• Published in: Abdominal radiology (New York) Vol. 46; no. 9; pp. 4210 - 4217
• Main Authors: Wen, Kan, Cen, Chunyuan, Wu, Leidi, Huang, Mengting, Yang, Hongli, Yue, Xiaofei, Zhang, Yu, Ma, Guina, Li, Xin, Han, Ping
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-09-2021
• Subjects: Gastroenterology; Hepatology; Imaging; Medicine; Medicine & Public Health; Pancreas; Radiology; Pancreatic endocrine insufficiency; CT imaging; Remnant pancreatic volume; Pancreatic surgery; Diabetes mellitus
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-021-03061-4

Objective
To evaluate the relationship between pancreatic parenchyma loss and early postoperative hyperglycemia in patients with benign pancreatic diseases.
Methods
A total of 171 patients with benign pancreatic tumors or chronic pancreatitis, whose preoperative fasting blood glucose (FBG) was normal and who underwent partial pancreatectomy were reviewed. The pancreatic volume was measured by CT imaging before and after the operation. According to their different pancreatic resection volume (PRV), 171 patients were divided into five groups: < 30%, 30%–39%, 40%–49%, 50%–59%, and ≥ 60%. The correlation between the PRV and postoperative FBG was investigated. According to the postoperative FBG value, the patients were divided into a hyperglycemia group (HG) and nonhyperglycemia group (non-HG) to explore the best cutoff value of the PRV between the two groups.
Results
There were significant differences in the postoperative FBG among the five groups (PRV < 30%, 30%–39%, 40%–49%, 50%–59%, and ≥ 60%). The PRV was positively correlated with postoperative FBG in the benign tumor group and chronic pancreatitis group (
R
 = 0.727 and 0.651, respectively). ROC curve analysis showed that the best cutoff value of the PRV between the HG (
n
 = 84) and non-HG (
n
 = 87) was 39.95% with an AUC = 0.898; the sensitivity was 89.29%, and the specificity was 82.76%.
Conclusion
There was a linear positive correlation between the postoperative FBG level and PRV. Patients with a PRV ≥ 40% are more likely to develop early postoperative hyperglycemia.