Prospective study on glycometabolic effects after varied surgical treatments of pancreatic neoplasm        CHEN Tao, JIN Gang, HU Xiangui, et al. Department of Pancreatic Surgery, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai 200433, China
Corresponding author: JIN Gang, E-mail: jingang@sohu.com
Abstract    Objective    To examine the effects of varied surgical treatments on glucose homeostasis and insulin secretion. Methods    Prospective study on 120 patients from January 2009 to November 2010 was done, including 76 patients(63.3%) with pancreatic cancer and 44 patients(36.7%) with benign pancreatic tumors. 64 patients were underwent pancreaticoduodenectomy and 56 patients were underwent distal pancreatectomy. We examined the preoperative and postoperative (the 1st, 3rd, 5th, 7th days and one month after operation) plasma concentrations of fasting glucose, insulin, c-peptide and glycated hemoglobin of all 120 patients. Results    Partial pancreatectomy leads to a reduction in insulin secretion approximately by 40% in both pancreatic cancer and benign pancreatic tumor patients (P<0.05).  However, pancreaticoduodenectomy reduces fasting glucose concentration in patients with pancreatic head cancer, especially in patients with diabetes mellitus, whereas distal pancreatectomy led to deterioration in fasting blood glucose in patients with benign pancreatic body-tail tumor (P<0.05). Conclusion    Glycometabolic effects after varied surgical treatments of pancreatic tumors are different. Pancreaticoduodenectomy can ameliorate glycometabolism in patients with pancreatic cancer, especially in patients with pancreatic cancer and diabetes mellitus.