title: Impact of preoperative diabetes mellitus on clinical outcome after pancreatectomy.
abstract: OBJECTIVE
  The goal of this study was to review published literature regarding the impact of preoperative diabetes mellitus (DM) in patients undergoing pancreatectomy.
  
  
  METHODS
  Ovid Medline(®) of a biomedical database was used on subjective literature research.
  
  
  RESULTS
  The prevalence of preoperative DM was 30.9-54.9% in patients with pancreatic cancer and was 5.3-10.8% in patients with chronic pancreatitis. There were few reports that described the relationship between preoperative DM status and postoperative morbidity/mortality, or long-term survival after pancreatectomy. The incidence of pancreatic fistula of Grade B and C [defined by International Study Group on Pancreatic Fistula Definition (ISGPF)] was similar when comparing patients with and without preoperative DM. Furthermore, the incidence of death and various morbidities (e.g., infections, cardiovascular complications, clinically significant level of acute renal failure after pancreatectomy, and delayed gastric emptying after pancreaticoduodenectomy) were not significantly different when comparing patients with and without preoperative DM. It is unclear whether preoperative DM has an impact on long-term survival after pancreatectomy, and the difficulty in assessing this parameter may be due to different definitions of DM, different surgical methods, and different comorbidities when comparing different studies.
  
  
  CONCLUSIONS
  The occurrence rates of postoperative mortality and morbidities including pancreatic fistula and renal failure of moderate to severe degrees were almost same between patients with and without preoperative DM. The influence of preoperative DM on long term survival after pancreatectomy should be elucidated by future studies under accurate and consistent definitions of DM.
authors.affiliation: Department of Surgery, Kashiwara Municipal Hospital, 1-7-9 Hozenji, Kashiwara City, Osaka 582-0005, Japan. Electronic address: bunzo@med.osaka-cu.ac.jp.
authors.forename: Bunzo
authors.initials: B
authors.lastname: Nakata
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Amano
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D003920:Diabetes Mellitus / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D010180:Pancreatectomy / Q000009:adverse effects*; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome
keywords: Chronic pancreatitis; Diabetes mellitus; Pancreatectomy; Pancreatic cancer