Time course change of the insulin requirements during the perioperative period in hepatectomy and pancreatectomy by using an artificial pancreas STG-55.

IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Diabetology International Pub Date : 2023-04-01 eCollection Date: 2023-07-01 DOI:10.1007/s13340-023-00623-3

Sanae Teshigawara, Atsuhito Tone, Akihiro Katayama, Yusuke Imai, Toshihisa Tahara, Mayumi Senoo, Satoko Watanabe, Mitsuhiro Kaneto, Yasuyuki Shimomura, Chiaki Yagi, Hiroki Kajioka, Toru Kojima, Takefumi Niguma, Tatsuaki Nakatou

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Abstract

Introduction: To investigate changes in insulin requirements over time in patients who underwent hepatectomy and pancreatectomy with perioperative glycemic control by an artificial pancreas (STG-55).

Materials and methods: We included 56 patients (22 hepatectomies and 34 pancreatectomies) who were treated with an artificial pancreas in the perioperative period and investigated the differences in insulin requirements by organ and surgical procedure.

Results: The mean intraoperative blood glucose level and total insulin doses were higher in the hepatectomy group than in the pancreatectomy group. The dose of insulin infusion increased in hepatectomy, especially early in surgery, compared to pancreatectomy. In the hepatectomy group, there was a significant correlation between the total intraoperative insulin dose and Pringle time, and in all cases, there was a correlation with surgical time, bleeding volume, preoperative CPR, preoperative TDD, and weight.

Conclusions: Perioperative insulin requirements may be mainly dependent on the surgical procedure, invasiveness, and organ. Preoperative prediction of insulin requirements for each surgical procedure contributes to good perioperative glycemic control and improvement of postoperative outcomes.

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应用STG-55人工胰腺进行肝切除术和胰切除术围手术期胰岛素需求的时程变化。

引言：研究接受肝切除术和胰腺切除术并通过人工胰腺（STG-55）控制围手术期血糖的患者胰岛素需求随时间的变化。材料和方法：我们纳入了56名在围手术期接受人工胰腺治疗的患者（22例肝切除术，34例胰腺切除术）器官和外科手术对胰岛素的需求。结果：肝切除组术中平均血糖水平和总胰岛素剂量高于胰切除组。与胰腺切除术相比，肝切除术中胰岛素输注的剂量增加，尤其是在手术早期。在肝切除组中，术中总胰岛素剂量与普林格尔时间之间存在显著相关性，在所有病例中，均与手术时间、出血量、术前心肺复苏术、术前TDD和体重相关。结论：围手术期胰岛素需求可能主要取决于手术方式、侵袭性和器官。术前预测每次手术的胰岛素需求有助于良好的围手术期血糖控制和改善术后结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetology International ENDOCRINOLOGY & METABOLISM-

CiteScore

3.90

自引率

4.50%

发文量

期刊介绍： Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.