title: Postoperative Closed-loop Glycemic Control Using an Artificial Pancreas in Patients After Esophagectomy.
abstract: OBJECTIVE
  This study investigated the efficacy of an artificial pancreas in managing postoperative glycemic levels for patients after esophagectomy.
  
  
  METHODS
  We reviewed 107 patients with esophageal cancer who underwent esophagectomy, and had postoperative glucose management using the artificial pancreas. The target blood glucose level (TBGL) range was 90-140 mg/dl. Achievement rate of TBGL, total insulin use, number of severe hypoglycemic (<40 mg/dl) events, surgical complications and length of hospitalization (LOH) were evaluated.
  
  
  RESULTS
  Mean achievement rate of TBGL was 78.2%. Mean total insulin use was 47.9 units. Mean blood glucose level was 136.3 mg/dl (mean SD=20.7). The incidences of pneumonia, anastomotic leak, and surgical site infection were 11.2%, 12.1%, 23.4%, respectively. The mean LOH was 29.6 days. No patient developed severe hypoglycemia.
  
  
  CONCLUSIONS
  Artificial pancreatic systems could minimize blood glucose variability and prevent severe hypoglycemic events for patients after esophagectomy.
authors.affiliation: Department of Surgery, Kochi Medical School, Nankoku, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitagawa
authors.affiliation: Department of Anesthesiology, Kochi Medical School, Nankoku, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Yatabe
authors.affiliation: Department of Surgery, Kochi Medical School, Nankoku, Japan tsutomun@kochi-u.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.affiliation: Department of Surgery, Kochi Medical School, Nankoku, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Munekage
authors.affiliation: Department of Surgery, Kochi Medical School, Nankoku, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose; D004938:Esophageal Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery* / Q000628:therapy*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019397:Pancreas, Artificial; D011182:Postoperative Care
chemical_list: D001786:Blood Glucose
keywords: Closed-loop glycemic control; artificial pancreas; continuous blood glucose control; esophagectomy