The loss of pancreatic parenchyma plays an important role in the pathogenesis of pancreoprivic diabetes 6, which is characterized by insulin deficiency and increased peripheral insulin sensitivity 7. Pancreoprivic diabetes develops in 12–20% of patients who undergo pancreaticoduodenectomy (PD) 4, 5. More than 75% of pancreoprivic diabetes result from chronic pancreatitis however, this form of diabetes mellitus is also caused by cystic fibrosis, pancreatic cancer, and pancreatic resection 3. The term ‘pancreoprivic diabetes’, historically referred to as type 3c diabetes mellitus, is used to define diabetes caused by loss or destruction of the endocrine pancreas 2. In conclusion, patients with severe PF are more likely to develop pancreoprivic diabetes after PD and have worse disease-free survival.ĭiabetes mellitus is classified as type 1 (β-cell destruction), type 2 (insulin resistance with secretory defect), and type 3 (other specific types) subtypes by the American Diabetes Association 1. The 5-year disease-free survival of patients with pancreatic cancer was worse with high-grade PF than low-grade PF (SMA, 24.5% vs. The SMA-TRC combined high-grade group had a higher proportion of primary pancreatic disease than the combined low-grade group (90.0% vs. The 1-year cumulative incidence of hyperglycemia/pancreoprivic diabetes was higher with high-grade PF than low-grade PF (SMA, 94.4% vs. High-grade PF was more common in the diabetes group than in the normal group (SMA, 42.5% vs. Sixty-one patients did not have preoperative diabetes, however, 40 (65.6%) patients developed pancreoprivic diabetes after PD. New-onset pancreoprivic diabetes and recurrence of disease were evaluated using fasting blood glucose measurement and radiography taken at 3-month intervals. PF grade was evaluated with alpha-smooth muscle actin (SMA) and Masson’s trichrome (TRC) staining. Ninety-five patients who underwent PD at Gangnam Severance Hospital between 20 were enrolled.
This study investigated the correlation between pancreatic fibrosis (PF) and development of pancreoprivic diabetes after pancreaticoduodenectomy (PD).