title: [Blood glucose control and risk of progressing to a diabetic state during clinical follow up after cephalic duodenopancreatectomy].
abstract: BACKGROUND
  Pancreatic resection carries a theoretical risk of developing diabetes; however few studies have demonstrated the effect of a cephalic duodenopancreatectomy on post-operative blood glucose control.
  
  
  METHODS
  An analysis was made of the post-operative clinical follow up of 70 patients subjected to a cephalic duodenopancreatectomy in our Hospital between March 1993 and November 2009. The surgical indication was due to primary pancreatic disease in 30 patients (21 adenocarcinoma of the pancreas, 6 chronic pancreatitis, 1 endocrine carcinoma, 1 cystadenoma and 1 complicated pseudocyst). The pancreas was not affected in the other 40 patients (24 ampullary carcinomas, 11 cholangiocarcinomas, 3 duodenal carcinomas, 1 papillary adenoma and 1 adenomatous hyperplasia of the bile duct). Data on the pre- and post-operative diabetic state were collected.
  
  
  RESULTS
  Before resection, 49 patients (70.0%) had a normal glucose without the need for treatment. Seventeen patients required oral diabetic treatment, 3 subcutaneous insulin, and only one was treated by diet. The duodenopancreatectomy worsened glucose control in 47.1% of the patients (23 of the previously non-diabetics and 10 of those treated with oral diabetics). Glucose control was worse when the surgical indication was due to primary involvement of the gland (progression of 63.3%) compared with patients with disease (progression of 35.0%) (P<.05).
  
  
  CONCLUSIONS
  Our results show that resection of the head of the pancreas favours the appearance of post-operative diabetes, particularly when the surgical indication is due to primary pancreatic involvement.
authors.affiliation: Sección de Cirugía Hepato-bilio-pancreática, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Valme, Sevilla, España. pabloparra@aecirujanos.es
authors.forename: Pablo
authors.initials: P
authors.lastname: Parra Membrives
authors.forename: Daniel
authors.initials: D
authors.lastname: Díaz Gómez
authors.forename: Darío
authors.initials: D
authors.lastname: Martínez Baena
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Lorente Herce
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000097:blood* / Q000209:etiology*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose