Table 1:
Demographic and peri-operative clinical variables of 1,717 patients who underwent distal pancreatectomy (DP) or pancreaticoduodenectomy (PD), at a single tertiary-care center between 2000 and 2015. (IDDM = insulin-dependent diabetes mellitus, NIDDM = non-insulin dependent diabetes mellitus)
| DP (n=421, 24.53%) |
PD (n=1296, 75.47%) |
Overall | |
|---|---|---|---|
| Age (mean ± SD) | 59.11±14.37 | 63.76 ±12.02 | 62.62 ± 12.79 |
| Male | 190 (45.13) | 699 (53.94) | 889 (51.78%) |
| Caucasian | 354 (84.09) | 1160 (89.51) | 1514 (88.18%) |
| BMI (mean ± SD) | 404, 29.20±6.60 | 1289,_ 27.09±5.58 | 27.59 ± 5.90 |
| Tobacco Use | 411, 105 (25.55) | 1294, 325 (25.12) | 1705, 430 (25.04%) |
| Alcohol Abuse | 405, 7 (1.73) | 1293, 59 (4.56) | 1688, 66 (3.89%) |
| Family History Diabetes | 402, 148 (36.82) | 1265, 348 (27.51) | 1667, 496 (28.89%) |
| Pathology | 414 | 1290 | 1704 |
| Malignant | 217 (52.42) | 1050 (81.40) | 1267 (74.35%) |
| Benign | 197 (47.58) | 240 (18.60) | 437 (25.65%) |
| Pancreatitis | 419, 55 (13.13) | 1296, 219 (16.90) | 1715, 274 (15.98%) |
| Steatorrhea | 386, 9 (2.33) | 1290, 412 (31.94) | 1676, 421 (25.12%) |
| Jaundice | 406. 3 (0.74) | 1293, 759 (58.70) | 1696, 762 (44.85%) |
| Abdominal Pain | 403, 241 (59.80) | 1290, 796 (61.71) | 1693, 1037 (61.25%) |
| Weight Loss | 393, 145 (36.90) | 1255, 717 (57.13) | 1648, 862 (52.31%) |
| Albumin (mean ± SD) | 384,_ 4.16±0.55 | 1274,_ 3.94±0.53 | 1658, 3.99 ± 0.54 |
| Bilirubin (mean ± SD) | 385,_ 0.43±0.32 | 1275,_ 3.44±5.74 | 1660, 2.74 ± 5.19 |
| Hemoglobin A1c (mean ± SD) | 76,_ 7.23±1.49 | 182,_ 7.23±1.57 | 258, 7.23 ± 1.54 |
| Pre-operative DM | |||
| No DM | 315 (74.82) | 955 (73.69) | 1270 (73.97%) |
| Type 1 – IDDM | 5 (1.19) | 20 (1.54) | 25 (1.46%) |
| Type 2 – IDDM | 26 (6.18) | 144 (11.11) | 170 (9.90%) |
| Type 2 – NIDDM | 75 (17.81) | 177 (13.66) | 252 (14.68%) |
| Adjuvant Therapy (% of total, % of malignant) | 419, 149 (35.56, ) | 1274, 620 (48.67, ) | 1693, 769 (45.42%, 60.69%) |
| Chemotherapy | 420, 146 (34.76, ) | 1272, 619 (48.66, ) | 1692, 765 (45.21%, 60.38%) |
| Radiation | 50 (11.90, ) | 314 (25.20, ) | 1666, 364 (21.85%, 28.73%) |
|
Follow-up, months
(median, range) |
20.64 (0.12–160.44) | 16.68 (0.12–192.72) | 17.88 (0.12 – 192.72) |
| Endocrine Insufficiency at Last Follow-up | 127 (30.17) | 219 (16.90) | 346 (20.15%) |
| Time from Surgery to Endocrine Onset in Months (mean ± SD (interquartile range)) |
22.46+24.91
(2.99–35.90) |
28.74+ 37.66
(1.81–41.11) |
27.20 ± 35.06 (2.14–39.35) |
| Diabetes Status at Last Follow-up | 192 | 472 | 664 |
| Type 1 – IDDM | 5 (2.60) | 20 (4.24) | 25 (3.77%) |
| Type 2 – IDDM | 120 (62.50) | 317 (67.16) | 437 (65.81%) |
| Type 2 – NIDDM | 67 (34.90) | 135 (28.60) | 202 (30.42%) |
| Pre-operative DM with No Change in Management | 64 (33.33) | 252 (53.39) | 316 (47.59%) |
| Type 1 – IDDM to Type 1 – IDDM | 5 (2.60) | 20 (4.24) | 25 (3.77%) |
| Type 2 – NIDDM to Type 2 – NIDDM | 33 (17.19) | 88 (18.64) | 121 (18.22%) |
| Type 2 – IDDM to Type 2 – IDDM | 26 (13.54) | 144 (30.51) | 170 (25.60%) |
| Pre-operative DM with Escalation of Regimen (Type 2 – NIDDM to Type 2 – IDDM) | 42 (21.88) | 89 (18.86) | 131 (19.73%) |
| No pre-operative DM to DM Post-operative | 86 (44.79) | 131 (27.76) | 217 (32.68%) |
| No DM to Type 2 – IDDM | 52 (27.08) | 84 (17.80) | 136 (20.48%) |
| No DM to Type 2 – NIDDM | 34 (17.71) | 47 (9.96) | 81 (12.20%) |
| Exocrine Insufficiency at Last Follow-up | 85 (20.19) | 537 (41.44) | 622 (36.23%) |
| Time from Surgery to Exocrine Onset in Months (mean ± SD (interquartile range)) |
24.26+26.31
(2.40–41.39) |
22.39 +35.54
(1.12–26.87) |
22.85 ± 33.52 (1.25-29.98) |