title: Does the pancreatic volume reduction rate using serial computed tomographic volumetry predict new onset diabetes after pancreaticoduodenectomy?
abstract: Volume reduction of the pancreatic tissues following a pancreatectomy can lead to the deterioration of glucose homeostasis. This is defined as pancreatogenic diabetes mellitus (DM). The objective of this study was to investigate the occurrence of new-onset DM (NODM) and evaluate the risk factors, including the pancreas volume reduction rate in patients undergoing pancreaticoduodenectomy (PD).Sixty-six patients without preoperative DM underwent PD for periampullary tumors between August 2007 and December 2012 and were included in this analysis. These patients underwent follow-up tests and abdominal computed tomography (CT) scan 7 days, 6 months, 12 months, 24 months, and 36 months after the operation. The pancreas volume reduction rate was calculated by CT volumetry. The patients were divided into 2 groups according to the postoperative development of DM.After PD, newly diagnosed DM occurred in 16 patients (24.2%). The incidence of DM was highest among patients with carcinomas with an advanced T stage. The pancreatic volume reduction rate after 6 and 12 months in the NODM group was significantly higher than the normal glucose group in the univariate analysis. In the multivariate analysis, the pancreatic volume reduction rate 6 months after PD was the only significant predictive factor for the development of NODM (P = 0.002).This study suggests that the pancreatic volume reduction rate 6 months after PD was the only significant predictive factor for the development of NODM. CT volumetry of the pancreas may be useful as a predictor of NODM after PD.
authors.affiliation: Department of Surgery Department of Radiology Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Sung Pil
authors.initials: SP
authors.lastname: Yun
authors.forename: Hyung-Il
authors.initials: HI
authors.lastname: Seo
authors.forename: Suk
authors.initials: S
authors.lastname: Kim
authors.forename: Dong Uk
authors.initials: DU
authors.lastname: Kim
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Baek
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed