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Association between pancreatic fibrosis and development of pancreoprivic diabetes after pancreaticoduodenectomy

 Jung Min Lee  ;  Hyung Sun Kim  ;  Minyoung Lee  ;  Ho Seon Park  ;  Shinae Kang  ;  Ji Hae Nahm  ;  Joon Seong Park 
 SCIENTIFIC REPORTS, Vol.11(1) : 23538-1, 2021-12 
Journal Title
Issue Date
Blood Glucose / metabolism ; Diabetes Mellitus / etiology* ; Diabetes Mellitus / metabolism ; Disease-Free Survival ; Female ; Fibrosis / complications* ; Fibrosis / metabolism ; Fibrosis / surgery* ; Humans ; Male ; Middle Aged ; Pancreas / metabolism ; Pancreas / surgery ; Pancreatic Diseases / complications* ; Pancreatic Diseases / metabolism ; Pancreatic Diseases / surgery* ; Pancreaticoduodenectomy / adverse effects*
This study investigated the correlation between pancreatic fibrosis (PF) and development of pancreoprivic diabetes after pancreaticoduodenectomy (PD). Ninety-five patients who underwent PD at Gangnam Severance Hospital between 2014 and 2017 were enrolled. PF grade was evaluated with alpha-smooth muscle actin (SMA) and Masson's trichrome (TRC) staining. New-onset pancreoprivic diabetes and recurrence of disease were evaluated using fasting blood glucose measurement and radiography taken at 3-month intervals. Sixty-one patients did not have preoperative diabetes, however, 40 (65.6%) patients developed pancreoprivic diabetes after PD. High-grade PF was more common in the diabetes group than in the normal group (SMA, 42.5% vs. 28.6%, P = 0.747; TRC, 47.5% vs. 28.6%, P = 0.361). The 1-year cumulative incidence of hyperglycemia/pancreoprivic diabetes was higher with high-grade PF than low-grade PF (SMA, 94.4% vs. 73.0%, P = 0.027; TRC, 89.3% vs. 75.0%, P = 0.074). The SMA-TRC combined high-grade group had a higher proportion of primary pancreatic disease than the combined low-grade group (90.0% vs. 37.5%, P = 0.001). 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. 66.3%, P = 0.026; TRC, 23.6% vs. 58.4%, P = 0.047). In conclusion, patients with severe PF are more likely to develop pancreoprivic diabetes after PD and have worse disease-free survival.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Ae(강신애) ORCID logo https://orcid.org/0000-0002-9719-4774
Kim, Hyung Sun(김형선) ORCID logo https://orcid.org/0000-0002-9002-3569
Nahm, Ji Hae(남지해) ORCID logo https://orcid.org/0000-0003-0902-866X
Park, Joon Seong(박준성) ORCID logo https://orcid.org/0000-0001-8048-9990
Lee, Minyoung(이민영) ORCID logo https://orcid.org/0000-0002-9333-7512
Lee, Jung Min(이정민)
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