Factors Affecting the Development of Diabetes Mellitus After Pancreatic Resection.

OBJECTIVES: Glucose homeostasis changes after pancreatic resection are not well understood. We aimed to identify the incidence of, and risk factors for, a change in glucose homeostasis in patients who underwent pancreatectomy for benign pancreatic tumors.

METHODS: Clinical and pathological data from 229 patients were collected prospectively and analyzed retrospectively. The pancreas resection volume was calculated by computed tomography volumetry.

RESULTS: After pancreatectomy, newly diagnosed diabetes mellitus (DM) occurred in 52 patients (22.7%) and impaired fasting glucose and impaired glucose tolerance occurred in 74 patients (32.3%). The incidence of DM was highest for patients who underwent distal pancreatectomy (DP) (30.5%). Patients in the DP group had a significantly increased rate of DM as the pancreatic resection volume (in milliliters) and resected volume ratio (in percent) increased. A high body mass index and older age were significant risk factors for the development of DM by multivariate analysis.

CONCLUSIONS: The resection volume of the pancreas is associated with a change in glucose homeostasis after pancreatectomy. Therefore, preservation of the pancreatic parenchyma is important to minimize the onset of DM in patients with a high pancreatic resected volume ratio (>35.6%) in DP, a high body mass index, or in old age.