title: Late complications after pancreaticoduodenectomy with pancreaticogastrostomy.
abstract: BACKGROUND
  We investigated complications after pancreaticoduodenectomy (PD) with pancreaticogastrostomy (PG) reconstruction more than 12 months postoperatively.
  
  
  METHODS
  Through chart review and outpatient follow-up, we assessed the incidence of new-onset diabetes mellitus (DM) and steatorrhea after PD.
  
  
  RESULTS
  Ninety patients underwent PD with PG with a median follow-up of 4.7 years (range 0.4-15.8 years). Of the 77 patients without DM preoperatively, 18 (23.4%) developed DM postoperatively. Those who developed DM were younger at time of surgery than those who did not (60.5 versus 65.8 years; p = 0.021), but postoperative survival did not differ between these groups. The incidence of DM was comparable to the incidence of DM in the general population. Out of 89 patients, 47 (52.8%) now require pancreatic enzyme therapy. The group that developed steatorrhea underwent PD at a younger age (61.4 versus 67.0 years; p = 0.029).
  
  
  CONCLUSIONS
  Patients that undergo PD at a younger age are more likely to develop DM and steatorrhea than their older counterparts; patients are as likely as the general population, however, to develop DM after PD with PG.
authors.affiliation: Department of Surgery, Loyola University Stritch School of Medicine, EMS 110-3236, 2160 S. 1st Avenue, Maywood, IL, USA.
authors.forename: Eileen Anne
authors.initials: EA
authors.lastname: Bock
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hurtuk
authors.forename: Margo
authors.initials: M
authors.lastname: Shoup
authors.forename: Gerard V
authors.initials: GV
authors.lastname: Aranha
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000379:methods; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods; D010193:Pancreaticojejunostomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D045602:Steatorrhea / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome