Safety of artificial pancreas in hepato-biliary-pancreatic surgery: A prospective study.
Artificial organ
Glucose tolerance
Infectious complication
Insulin resistance
Perioperative care
Journal
Asian journal of surgery
ISSN: 0219-3108
Titre abrégé: Asian J Surg
Pays: Netherlands
ID NLM: 8900600
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
24
12
2018
revised:
17
02
2019
accepted:
11
03
2019
pubmed:
6
5
2019
medline:
25
9
2020
entrez:
5
5
2019
Statut:
ppublish
Résumé
An artificial pancreas (AP) is useful for intensive insulin treatment (IIT). In this study, the safety and efficacy of an AP in the perioperative period of highly invasive hepato-biliary and pancreatic surgery (HBPS) was validated. Fifty patients underwent IIT with an AP during the HBPS perioperative period, including hepatectomy greater than two sectors (MH), pancreatoduodenectomy (PD), and liver transplantation (LT). The primary endpoint was occurrence of hypoglycemia (<60 mg/dL). Secondary endpoints were perioperative glycemic control and postoperative complications. This study was registered at UMIN-CTR (UMIN000016451). The mean patient age was 62.8 years. The most common surgical procedures were PD (n=24, 48%), MH (n=22, 44%), and LT (n=4, 8%). No hypoglycemia occurred in this study. The mean glycemic control rate and coefficient of variation of blood glucose during AP use were 26.4 ± 21.2% and 16.2 ± 8.3, respectively. The mean blood glucose level was 122.9 ± 15.7 mg/dL during AP application. The AP was safe during IIT, with no hypoglycemia observed perioperatively in patients who underwent highly invasive HBPS. Further studies are required to address the efficacy of AP with IIT in highly invasive situations.
Sections du résumé
BACKGROUND
BACKGROUND
An artificial pancreas (AP) is useful for intensive insulin treatment (IIT). In this study, the safety and efficacy of an AP in the perioperative period of highly invasive hepato-biliary and pancreatic surgery (HBPS) was validated.
METHODS
METHODS
Fifty patients underwent IIT with an AP during the HBPS perioperative period, including hepatectomy greater than two sectors (MH), pancreatoduodenectomy (PD), and liver transplantation (LT). The primary endpoint was occurrence of hypoglycemia (<60 mg/dL). Secondary endpoints were perioperative glycemic control and postoperative complications. This study was registered at UMIN-CTR (UMIN000016451).
RESULTS
RESULTS
The mean patient age was 62.8 years. The most common surgical procedures were PD (n=24, 48%), MH (n=22, 44%), and LT (n=4, 8%). No hypoglycemia occurred in this study. The mean glycemic control rate and coefficient of variation of blood glucose during AP use were 26.4 ± 21.2% and 16.2 ± 8.3, respectively. The mean blood glucose level was 122.9 ± 15.7 mg/dL during AP application.
CONCLUSION
CONCLUSIONS
The AP was safe during IIT, with no hypoglycemia observed perioperatively in patients who underwent highly invasive HBPS. Further studies are required to address the efficacy of AP with IIT in highly invasive situations.
Identifiants
pubmed: 31053475
pii: S1015-9584(18)30817-0
doi: 10.1016/j.asjsur.2019.03.011
pii:
doi:
Substances chimiques
Blood Glucose
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
201-206Informations de copyright
Copyright © 2019. Published by Elsevier Taiwan LLC.