Metabolic consequences of (regional) total pancreatectomy.

摘要: Little information has been reported on the metabolic characteristics of totally pancreatectomized patient or efficacy medical management after radical pancreatic surgery. The prospective evaluation 49 such patients, with 31% followed for 48 more months, forms basis this report. major immediate postoperative challenge is control diarrhea and weight stabilization. Chronically patients have an increased daily caloric requirement (mean +/- SE, 56 1 kcal/kg), not wholly explained by moderate steatorrhea (fecal fat excretion, 16% 2% unrestricted intake). Despite persistent malabsorption, deficiencies in fat-soluble vitamin, magnesium, trace element serum levels can be prevented most patients. Pancreatogenic diabetes characterized (1) absence glucoregulatory hormones insulin glucagon, (2) instability, (3) frequent hypoglycemia, latter parameters improving rigorous home glucose monitoring. No developed clinically overt diabetic micro- macrovascular disease. Performance status long-term survivors reasonable. However adverse chronic sequelae operation occur include unusual frequency liver disease, accelerated fatty infiltration, osteopenia, 18% reduction radial bone mineral content noted studied than 5 years