Impact of diabetes mellitus on morbidity and survival after pancreaticoduodenectomy for malignancy
| العنوان: | Impact of diabetes mellitus on morbidity and survival after pancreaticoduodenectomy for malignancy |
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| المؤلفون: | Rajesh Gupta, Sunil D. Shenvi, Surinder Singh Rana, Gautham Krishnamurthy, Kunal Bikram Deo, Rakesh Kapoor, Aditya Kulkarni, Praveen Kumar-M |
| المصدر: | Annals of Hepato-Biliary-Pancreatic Surgery |
| بيانات النشر: | The Korean Association of Hepato-Biliary-Pancreatic Surgery, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, medicine.medical_treatment, Perineural invasion, Malignancy, Gastroenterology, Pancreaticoduodenectomy, Diabetes mellitus, Internal medicine, medicine, Risk factor, Survival analysis, Periampullary carcinoma, Transplantation, Hepatology, Gastric emptying, business.industry, medicine.disease, Periampullary Adenocarcinoma, Pancreatic fistula, Surgery, Original Article, business, Pancreatic adenocarcinoma |
| الوصف: | Backgrounds/aims Diabetes mellitus (DM) is a known risk factor for morbidity, length of hospital stay, or mortality after surgery, however, its impact on postoperative course and long-term survival after pancreaticoduodenectomy (PD) is not clear. Methods This is a retrospective analysis of prospectively maintained database of 141 patients with periampullary and pancreatic head adenocarcinoma operated between January 2001 and March 2019. Clinico-pathological records and follow-up data were retrieved and analyzed. Cumulative hazard was computed for comparing the survival between DM and non-DM. Results DM was present in 31/141 (21.9%) patients, while 16/31 (51.6%). were new-onset DM (NODM). Tumor size, lymphovascular & perineural invasion, type of surgery, lymph node positivity and R0 resection rate were comparable between diabetic and non-diabetic. There was no significant difference in postoperative pancreatic fistula, delayed gastric emptying, infectious complication, hospital stay and mortality between DM and nondiabetics. Patients with DM had worse survival at 3 years (OS: HR, 3.11 [1.43-6.76] p=0.004, DFS: HR, 2.61 [1.23-5.53] p=0.01) and 5 years (OS: HR, 3.32 [1.46-7.53] p=0.004, DFS: HR, 2.87 [1.29-6.41] p=0.009). On multivariate analysis, DM (3 year OS: HR, 2.61 [1.14-5.98] p=0.022, DFS: HR, 2.19; p=0.058) (5 year OS: HR, 2.55; p=0.04, DFS: HR, 2.25; p=0.068) and pylorus resecting surgery were significantly associated with worse survival at 3 and 5 years. Conclusions Preoperative DM has no significant effect on postoperative course but has negative impact on 3-year and 5-year OS and DFS after PD for pancreatic and periampullary adenocarcinoma. |
| اللغة: | English |
| تدمد: | 2508-5859 2508-5778 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2faed3a59f77a795e81d8e1a5417816e http://europepmc.org/articles/PMC8180397 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....2faed3a59f77a795e81d8e1a5417816e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 25085859 25085778 |
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