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Metabolic consequences of the occlusion of the main pancreatic duct with acrylic glue after pancreaticoduodenectomy.

Authors :
Mezza T
Clemente G
Sorice GP
Conte C
De Rose AM
Sun VA
Cefalo CM
Pontecorvi A
Nuzzo G
Giaccari A
Source :
American journal of surgery [Am J Surg] 2015 Oct; Vol. 210 (4), pp. 783-9. Date of Electronic Publication: 2015 Apr 30.
Publication Year :
2015

Abstract

Background: Pancreaticoduodenectomy represents the major treatment for pancreatic and periampullary neoplasms. Complications related to pancreaticojejunostomy are still the leading cause of morbidity and mortality. A solution proposed by some surgeons is the occlusion of main pancreatic duct by acrylic glue, avoiding pancreaticojejunostomy. Nevertheless, the consequences of this procedure on glucose metabolism are not well-defined.<br />Methods: We retrospectively analyzed a cohort of 50 patients who underwent pancreaticoduodenectomy and had metabolic assessments available. The metabolic evaluation included the following: body composition and clinical evaluation, an oral glucose tolerance test, and an hyperinsulinemic euglycemic clamp procedure.<br />Results: Twenty-three patients underwent pancreatic duct occlusion and were compared with 27 patients, well-matched controls, who underwent pancreaticojejunostomy. Pancreatic duct occlusion leads to a greater impairment in insulin secretion compared with classic pancreaticojeunostomy.<br />Conclusion: Pancreatic duct occlusion is associated with a greater reduction in insulin secretion but does not lead to meaningful differences in the management of patients with diabetes.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1879-1883
Volume :
210
Issue :
4
Database :
MEDLINE
Journal :
American journal of surgery
Publication Type :
Academic Journal
Accession number :
26004536
Full Text :
https://doi.org/10.1016/j.amjsurg.2014.12.052