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. 2021 Sep;46(9):4210-4217.
doi: 10.1007/s00261-021-03061-4. Epub 2021 Apr 4.

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

Kan Wen  1   2 , Chunyuan Cen  1   2 , Leidi Wu  1   2 , Mengting Huang  1   2 , Hongli Yang  1   2 , Xiaofei Yue  1   2 , Yu Zhang  1   2 , Guina Ma  1   2 , Xin Li  1   2 , Ping Han  3   4
Affiliations

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

Kan Wen et al. Abdom Radiol (NY). 2021 Sep.

Abstract

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.

Keywords: CT imaging; Diabetes mellitus; Pancreatic endocrine insufficiency; Pancreatic surgery; Remnant pancreatic volume.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of patient enrollment
Fig. 2
Fig. 2
a–d A schematic diagram of the volume of the pancreas. Female, 30 y, with a solid pseudopapillary tumor pathologically, underwent distal pancreatectomy and splenectomy. a Preoperative CT image. b A locally magnified picture of a region from (a). c Postoperative CT image. d A locally magnified picture of a region from (c). The volume of the pancreas was 52.45 cm3 before the operation and 31.88 cm3 after the operation
Fig. 3
Fig. 3
a Correlation analysis between PRV and postoperative FBG in 171 patients with benign pancreatic diseases, R = 0.691, P < 0.001. b Correlation analysis between PRV and postoperative FBG in 118 patients with benign pancreatic tumor, R = 0.727, P < 0.001. c Correlation analysis between PRV and postoperative FBG in 53 patients with chronic pancreatitis, R = 0.651, P < 0.001
Fig. 4
Fig. 4
a ROC curve of the HG group and non-HG group in 171 patients with benign pancreatic diseases, AUC = 0.898, P < 0.001; b ROC curve of the HG group and non-HG group in 118 patients with benign pancreatic tumor, AUC = 0.909, P < 0.001
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