Outcomes and quality of life after partial pancreatectomy for noninsulinoma pancreatogenous hypoglycemia from diffuse islet cell disease.
Outcomes and quality of life after partial pancreatectomy for noninsulinoma pancreatogenous hypoglycemia from diffuse islet cell disease.
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DOI：
10.1016/j.surg.2010.09.027
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发表时间：
2010-12
期刊：
影响因子：
3.8
通讯作者：
Service, F. John
中科院分区：
文献类型：
--
作者：
Vanderveen, Kimberly A.;Grant, Clive S.;Thompson, Geoffrey B.;Farley, David R.;Richards, Melanie L.;Vella, Adrian;Vollrath, Brenda;Service, F. John
非胰岛素瘤性胰源性低血糖症（NIPH）是一种罕见的原因，低血糖症的过度胰岛素分泌，特别是影响减肥手术后的患者。部分胰腺切除术可控制低血糖;然而，多名患者出现症状复发。我们的研究目的是评估术后复发症状的频率和严重程度。回顾了1996年1月至2008年12月在马约诊所接受胰腺切除术治疗NIPH的所有患者的人口统计学资料、术前检查、手术和术后详细信息。患者记录和邮件调查（包括欧洲生活质量调查（EQ-5D）和恐惧低血糖量表（FOHS-98））用于评估结局。75例患者因NIPH接受胰腺切除术。48例患者（70%）完成了调查（中位随访时间为53个月）。至症状复发的中位时间为16个月（N=41，87%）。尽管症状复发，75%的患者报告生活质量总体改善，心理压力和低血糖症状明显减轻（FOHS-98评分降低50%以上（p<0.001））。总体而言，半数患者被归类为高度/中度手术成功。然而，25%的患者没有明显的获益。尽管近90%的NIPH患者报告了提示低血糖的复发症状，但大多数患者报告了胰腺切除术后生活质量的显著改善和其他症状的显著减轻。
Noninsulinoma pancreatogenous hypoglycemia (NIPH) is a rare cause of hypoglycemia from excessive insulin secretion, especially affecting post-bariatric surgery patients. Partial pancreatectomy may control hypoglycemia; however, multiple patients experienced symptomatic relapse. Our study goal was to assess frequency and severity of recurrent symptoms postoperatively. Demographics, preoperative testing, operative and postoperative details were reviewed for all patients who underwent pancreatic resection for NIPH at Mayo Clinic from January 1996 - December 2008. Patient records and mail surveys (including European Quality of Life Survey (EQ-5D) and Fear of Hypoglycemia Scale (FOHS-98)) were used to assess outcome. 75 patients underwent pancreatic resection for NIPH. 48 patients (70%) completed the survey (median follow-up 53 mo.). Median time to recurrent symptoms was 16 months (N=41, 87%). Despite symptom recurrence, 75% of patients reported overall improvement in quality of life, with marked reduction in psychological stress and hypoglycemic symptoms (greater than 50% decrease in FOHS-98 scores (p<0.001). Overall, half of the patients were classified as highly/moderately surgically-successful. Nevertheless, 25% of patients experienced no apparent benefit. Although nearly 90% of NIPH patients reported recurrent symptoms suggestive of hypoglycemia, a majority reported significant improvements in QOL and marked reduction in other symptoms after pancreatic resection.
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