title: Clinicophysiological outcomes after total pancreatectomy.
abstract: OBJECTIVE
  Total pancreatectomy (TP) for pancreatic neoplasms is associated with high morbidity and mortality rates. However, with recent advances in surgical techniques and improved postoperative management, the number of cases with clinical indications for TP is increasing. Here, we evaluated the clinical outcomes post-TP.
  
  
  METHODS
  Patients (n = 41) who underwent TP between 2004 and 2011 at Tokyo Women's Medical University were retrospectively examined. Pre- and postoperative clinicophysiological data were collected up to 12 months post-TP and then analyzed.
  
  
  RESULTS
  Only glycated hemoglobin (HbA1c), percentage of lymphocytes and hepatic Hounsfield unit level on computed tomography (CT) were significantly different between the preoperative state and at 12 months post-TP, while other clinicophysiological parameters remained unchanged. The quantity of the pancreatic enzyme administered significantly influenced glycemic control at 12 months post-TP (p < 0.05).
  
  
  CONCLUSIONS
  All clinicophysiological parameters except for HbA1c were temporarily decreased after TP but normalized by 12 months. Thus, TP is a feasible surgical approach to treating pancreatic neoplasms with the potential to spread across the entire pancreas when adequately supplemented by synthetic insulin and pancreatic enzymes.
authors.affiliation: a Department of Gastroenterological Surgery , Tokyo Women's Medical University , Tokyo , Japan.|b Department of Gastroenterological Surgery , Ibaraki Medical Center, Tokyo Medical University , Ibaraki , Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: c Diabetes Center , Tokyo Women's Medical University , Tokyo , Japan.
authors.forename: Junnosuke
authors.initials: J
authors.lastname: Miura
authors.affiliation: d Department of Gastroenterology , Tokyo Women's Medical University , Tokyo , Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: d Department of Gastroenterology , Tokyo Women's Medical University , Tokyo , Japan.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Tokushige
authors.affiliation: c Diabetes Center , Tokyo Women's Medical University , Tokyo , Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Uchigata
authors.affiliation: a Department of Gastroenterological Surgery , Tokyo Women's Medical University , Tokyo , Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D001786:Blood Glucose; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D007564:Japan; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery* / Q000628:therapy; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D012044:Regression Analysis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin
keywords: Total pancreatectomy; glycemic control; pancreatic enzyme; pancreatic neoplasms; synthetic insulin