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Hempel, S.* ; Oehme, F.* ; Ehehalt, F. ; Solimena, M. ; Kolbinger, F.R.* ; Bogner, A.* ; Welsch, T.* ; Weitz, J.* ; Distler, M.

The impact of pancreatic head resection on blood glucose homeostasis in patients with chronic pancreatitis.

J. Clin. Med. 11:663 (2022)

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Background: Chronic pancreatitis (CP) often leads to recurrent pain as well as exocrine and/or endocrine pancreatic insufficiency. This study aimed to investigate the effect of pancreatic head resections on glucose metabolism in patients with CP. Methods: Patients who underwent pylorus‐preserving pancreaticoduodenectomy (PPPD), Whipple procedure (cPD), or duodenum-preserving pancreatic head resection (DPPHR) for CP between January 2011 and December 2020 were retrospectively analyzed with regard to markers of pancreatic endocrine function including steady‐state beta cell function (%B), insulin resistance (IR), and insulin sensitivity (%S) according to the updated Homeostasis Model Assessment (HOMA2). Results: Out of 141 pancreatic resections for CP, 43 cases including 31 PPPD, 2 cPD and 10 DPPHR, met the inclusion criteria. Preoperatively, six patients (14%) were normoglycemic (NG), 10 patients (23.2%) had impaired glucose tolerance (IGT) and 27 patients (62.8%) had diabetes mellitus (DM). In each subgroup, no significant changes were observed for HOMA2‐%B (NG: p = 0.57; IGT: p = 0.38; DM: p = 0.1), HOMA2‐IR (NG: p = 0.41; IGT: p = 0.61; DM: p = 0.18) or HOMA2‐%S (NG: p = 0.44; IGT: p = 0.52; DM: p = 0.51) 3 and 12 months after surgery, respectively. Conclusion: Pancreatic head resections for CP, including DPPHR and pancreatoduodenectomies, do not significantly affect glucose metabolism within a follow‐up period of 12 months.

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