Scientific Articles
Short and medium term glycaemic control after pancreaticoduodenectomy
Authors:
R. C. Siriwardana ,
University of Kelaniya, LK
About R. C.
Department of Surgery
L. M. P. M. Bandara,
University of Kelaniya
About L. M. P. M.
Department of Surgery
N. Atulugama,
National Cancer Hospital, Maharagama, LK
M. B. Gunathilke,
University of Kelaniya, LK
About M. B.
Department of Surgery
C. S. Ekanayake
University of Kelaniya
About C. S.
Department of Surgery
Abstract
Introduction
Perioperative outcomes of pancreaticoduodenectomy (PD) have improved over the years. Glycaemic control in longterm survivors is a matter of concern.
Materials and methods
48 surviving patients of 66 patients who underwent Whipple surgery from 2011 to 2015 were evaluated. Patients with recurrences, who had chemotherapy within three months and patients who had not completed a minimum six months follow-up were excluded. 25 patients were selected. Patients' demographic data, HbA1c level, fasting blood sugar level, physical activity index and waist to hip ratio were calculated. Volume of the pancreatic specimen was calculated. Non diabetics underwent oral glucose tolerance test (OGTT).
Results
There were 6 (24%) pre-existing diabetics, 3 new onset diabetics and two patients with impaired glucose tolerance (20%). Median preoperative BMI, body fat distribution, calculated median pancreatic volumes resected or underlying pancreatic pathology did not differ in diabetic and non-diabetic groups. In non-diabetics, HbA1c level or two hour OGTT did not associate with age, preoperative BMI, waist to hip ratio and resected pancreatic volumes.
Conclusion
Significant proportion of patients develop diabetes immediately after PD. Reliable prediction of this group pre-operatively is difficult due to many interacting, confounding factors. They need close monitoring in immediate perioperative period.
How to Cite:
Siriwardana RC, Bandara LMPM, Atulugama N, Gunathilke MB, Ekanayake CS. Short and medium term glycaemic control after pancreaticoduodenectomy. Sri Lanka Journal of Surgery. 2016;34(4):11–5. DOI: http://doi.org/10.4038/sljs.v34i4.8315
Published on
31 Dec 2016.
Peer Reviewed
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