title: Long-term effects of pancreaticoduodenectomy on glucose metabolism.
abstract: BACKGROUND
  To analyse the association between pancreatogenic diabetes and the volume of the remnant pancreas after pancreaticoduodenectomy and to identify clinicopathologic factors correlated with pancreatogenic diabetes.
  
  
  METHODS
  Among the patients who underwent pancreaticoduodenenctomy from 2003 to 2004, 55 patients who survived by 2009 and were able to measure the volume of the pancreas pre- and post-operatively by CT volumetry were included in this study. Twelve patients had diabetes before surgery. Median follow-up duration was 55.2 and 67.3 months for CT volumetry, pancreatogenic diabetes, respectively.
  
  
  RESULTS
  Among 43 patients without preoperative diabetes, nine patients (21%) developed newly diabetes after surgery. Among 12 patients with diabetes, 10 patients had worsened glucose control. The immediate post-operative Vol% was 46.5% and the last Vol% was 31.5% (P < 0.001). Preoperative diabetes, malignant pathology, absence of post-operative pancreatic fistula, chemotherapy and radiotherapy were correlated with a lower Vol%. Atrophic changes were observed in 29 patients and hypertrophic changes in 13 patients. Comparative analysis according to the change in the Vol% revealed no differences in the clinicopathological factors associated with new-onset pancreatogenic diabetes or aggravation of preoperative diabetes.
  
  
  CONCLUSIONS
  While some patients had a hypertrophic pancreas at the last follow-up, which reflected the capacity for pancreatic regeneration and some factors were associated with a lower volume of the remnant pancreas, the volume of the remnant pancreas seem not to be associated with pancreatogenic diabetes. There were no clinicopathologic factors identified associated with the risk for pancreatogenic diabetes.
authors.affiliation: Department of Surgery, The Catholic University of Korea St. Vincent's Hospital, Suwon Department of Surgery, Samsung Medical Center, Sungkyunkwan UniversitySchool of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, Korea.
authors.forename: Dong-Do
authors.initials: DD
authors.lastname: You
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Dong-Wook
authors.initials: DW
authors.lastname: Choi
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Heo
authors.forename: Cheon-Yu
authors.initials: CY
authors.lastname: Ho
authors.forename: Woo-Seok
authors.initials: WS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D054893:Cone-Beam Computed Tomography; D003920:Diabetes Mellitus / Q000097:blood / Q000209:etiology*; D004379:Duodenal Neoplasms / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001786:Blood Glucose