Relationship Between Remnant Pancreatic Volume and Endocrine Function After Pancreaticoduodenectomy

Am Surg. 2022 Feb;88(2):233-237. doi: 10.1177/0003134821989049. Epub 2021 Jan 30.

Abstract

Background: Decreased pancreatic volume (PV) is a predictive factor for diabetes mellitus (DM) after surgery. There are few reports on PV and endocrine function pre- and post-surgery. We investigated the correlation between PV and insulin secretion.

Methods: Seventeen patients underwent pancreaticoduodenectomy (PD) Pre- and post-surgery PV and C-peptide index (CPI) measurements were performed. Additionally, the correlation between PV and CPI was analyzed.

Results: The mean preoperative PV (PPV) was 55.1 ± 31.6 mL, postoperative remnant PV (RPV) was 25.3±17.3 mL, and PV reduction was 53%. The mean preoperative C-peptide immunoreactivity (CPR) was 1.39 ± .51 and postoperative CPR was .85±.51. The mean preoperative CPI was 1.29±.72 and postoperative CPI was .73 ± .48. Significant correlations were observed between RPV and post CPR (ρ = .507, P = .03) and post CPI (ρ = .619, P = .008).

Discussion: There was a significant correlation between RPV and CPI after PD. A smaller RPV resulted in lower insulin secretion ability, increasing the potential risk of new-onset DM after PD.

Keywords: C-peptide index; diabetes mellitus; insulin secretion; pancreatic volume; pancreaticoduodenectomy.

MeSH terms

  • Aged
  • C-Peptide / analysis*
  • Diabetes Mellitus / etiology
  • Female
  • Humans
  • Insulin / metabolism*
  • Male
  • Multidetector Computed Tomography
  • Organ Size
  • Pancreas / anatomy & histology*
  • Pancreas / diagnostic imaging
  • Pancreas / metabolism*
  • Pancreas / surgery
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy* / adverse effects
  • Postoperative Complications / etiology
  • Postoperative Period
  • Preoperative Period
  • Retrospective Studies

Substances

  • C-Peptide
  • Insulin