Impact of using a perioperative artificial endocrine pancreas in pancreatic resection.
Impact of using a perioperative artificial endocrine pancreas in pancreatic resection.
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DOI：
10.1002/ags3.12374
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发表时间：
2020-09
影响因子：
2.7
通讯作者：
Shimada M
中科院分区：
文献类型：
--
作者：
Yoshimoto T;Ikemoto T;Morine Y;Imura S;Saito Y;Yamada S;Miyazaki K;Takehara Y;Shimada M
胰腺切除术会导致继发于手术应激的高血糖和胰腺糖尿病，从而导致术后血糖水平难以控制。我们研究了围手术期使用人工胰腺来提供适当的血糖控制是否可以减少胰腺切除术后的并发症。我们回顾性纳入了 2015 年至 2019 年在德岛大学医院接受胰腺切除术的 52 名患者。最近的 26/52 名患者接受了使用人工胰腺的围手术期血糖控制。早期 26 名患者（对照）采用基于滑动量表的手动胰岛素注射进行术后血糖控制。我们比较了人工胰腺组和对照组的手术结果。术后第1天患者的白细胞或中性粒细胞计数、预后营养指数、中性粒细胞/淋巴细胞比值、C反应蛋白/白蛋白比值无显着差异；然而，人工胰腺组的淋巴细胞计数较高。人工胰腺组中 Clavien‐Dindo 分级 > IIIa 级严重并发症的数量显着较低 (P < .05)。使用人工胰腺对接受胰腺切除术的患者进行围手术期血糖控制，通过适当管理血糖水平而不会出现低血糖，从而减少了严重并发症的数量，并且可能会影响外周淋巴细胞。使用人工胰腺对接受胰腺切除术的患者进行围手术期血糖控制，通过适当管理血糖水平而不会出现低血糖，从而减少了严重并发症的数量，并且可能会影响外周淋巴细胞。
Pancreatectomy causes both hyperglycemia, secondary to surgical stress, and pancreatic diabetes, which leads to difficult‐to‐control postoperative blood glucose levels. We investigated whether using an artificial pancreas perioperatively to provide appropriate blood glucose control could reduce postoperative complications following pancreatectomy. We retrospectively enrolled 52 patients who underwent pancreatectomy at Tokushima University Hospital from 2015 to 2019. The most recent 26/52 patients received perioperative blood glucose control using an artificial pancreas. Postoperative blood glucose control with manual insulin injections based on a sliding scale was performed in the earlier 26 patients (controls). We compared surgical outcomes between the artificial pancreas group and the control group. There was no significant difference in patients' white blood cell or neutrophil counts, prognostic nutritional index, neutrophil‐lymphocyte ratio, and C‐reactive protein‐to‐albumin ratio on postoperative day 1; however, lymphocyte counts were higher in the artificial pancreas group. The number of serious complications of Clavien‐Dindo grade >IIIa was significantly lower in the artificial pancreas group (P < .05). Using an artificial pancreas for perioperative blood glucose control in patients undergoing pancreatectomy decreased the number of serious complications through proper management of blood glucose levels without hypoglycemia, and may influence peripheral lymphocytes. Using an artificial pancreas for perioperative blood glucose control in patients undergoing pancreatectomy decreased the number of serious complications through proper management of blood glucose levels without hypoglycemia, and may influence peripheral lymphocytes.
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作者：
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