Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump
Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump
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DOI：
10.1007/s00423-008-0437-9
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发表时间：
2010-01-01
影响因子：
2.3
通讯作者：
Blomme, Adri M.
中科院分区：
文献类型：
--
作者：
Haveman, Jan Willem;Logtenberg, Susan J. J.;Blomme, Adri M.
在选定的糖尿病受试者中，使用植入式胰岛素泵进行持续腹膜内胰岛素输注（CIPII）是安全有效的。我们的目的是评估CIPII的手术经验和并发症。我们对1990年至2006年开始使用CIPII的患者进行了一项回顾性纵向观察队列研究。比较2000年以前和2000年以后开始CIPII的患者的无手术期和并发症发生率。再手术是由于电池寿命结束（47%）、腹腔镜导管相关手术（29%）和其他干预（24%）导致的泵更换。自2000年起，中位无手术期从21个月增加到78个月（p = 0.039）。19%的患者出现并发症。无手术相关死亡报告，经验增加加上技术改进导致无手术期延长。无手术相关死亡率和低并发症发生率使得CIPII对选定的糖尿病患者可行。
Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump is safe and effective in selected subjects with diabetes. Our aim was to assess surgical experience and complications with CIPII.We performed a retrospective longitudinal observational cohort study of patients that started with CIPII from 1990 to 2006. Operation free period and complication rate were compared between patients initiating CIPII before 2000 and from 2000 onwards.In 63 patients, 166 re-operations were performed during 381 patient-years. Re-operations were pump replacement due to end-of-battery life (47%), laparoscopic catheter-related procedures (29%) and other interventions (24%). Median operation free period increased from 21 to 78 months from 2000 onwards (p = 0.039). Nineteen percent of patients developed complications. No operation-related mortality was reported.Increased experience together with technical improvements has led to an increase of the operation free period. The absence of procedure-related mortality and a low complication rate makes CIPII feasible for selected patients with diabetes.