Ann Hepatobiliary Pancreat Surg.  2024 Aug;28(3):364-370. 10.14701/ahbps.24-004.

Pancreatic volume and endocrine function changes following pancreaticoduodenectomy for peri-ampullary neoplasms: A retrospective single-center study utilizing pancreas volumetry

• Yang J
• Park YH
• Kim D
• Lee DH

• KMID: 2558653
• DOI: http://doi.org/10.14701/ahbps.24-004

Abstract

Backgrounds/Aims
We evaluated long-term pancreatic functional outcomes, including pancreatic volumetry after pancreaticoduodenectomy (PD) for peri-ampullary neoplasm.
Methods
We retrospectively reviewed 353 patients with a 12-month follow-up who underwent elective pancreaticoduodenectomies for peri-ampullary neoplasms at a single university hospital between January 2011 and December 2020. Perioperative and postoperative outcomes, long-term pancreatic endocrine functions, and pancreatic volume changes 12 month postoperatively were evaluated.
Results
The mean age was 65.4 years, and the sex ratio was 1.38. The patients with prediagnosed diabetes mellitus (DM) comprised 31.4%. The peri-ampullary neoplasm origins were: the pancreas (49.0%), common bile duct (27.2%), ampulla of Vater (18.4%), and duodenum (5.4%). The 1-week, and 3-, 6-, and 12-month postoperative proportions of patients with DM diagnosed before surgery combined with new-onset postoperative DM were 39.7%, 42.8%, 43.9%, and 49.6%, respectively. The preoperative and postoperative 1-week, and 3-, 6-, and 12-month mean pancreatic volumes were 82.3, 38.7, 28.1, 24.9, and 25.5 mL, respectively. Univariate risk factor analyses for new-onset DM after PD observed no significant difference between the ‘No DM after PD’ and ‘New-onset DM after PD’ groups.
Conclusions
Following PD for peri-ampullary neoplasms, pancreatic endocrine functions and volumes continued to decrease for a minimum of 12 months. The current study did not identify any causal relationship between pancreatic endocrine dysfunction and pancreatic atrophy following PD.

Keyword

Pancreaticoduodenectomy; Pancreatic fistula; Follow-up studies; Diabetes mellitus; Pancreas

Figure

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  Fig. 1 (A) AVIEW software (Version 1.1; Coreline Soft Co., Ltd.) for pancreas volumetry. (B) Pancreas volumetry and 3D reconstruction. (C) The pancreas was segmented manually to define the region of interest using the AVIEW software.

Reference

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