Pancreatic endocrine function depends on remaining pancreatic parenchyma volume irrespective of resection portion

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 758-775-Beta Cells, Glucose Control & Complications
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-759
Tsuguka Shiwa*, Masayasu Yoneda, Tomokazu Awaya, Takeshi Sudo, Kenichiro Uemura, Yoshiaki Murakami and Shuhei Nakanishi
Hiroshima University, Japan
Background: The form of glucose intolerance as a result of pancreatic resection is different between resection portions of the gland. However, there are limited data concerning endocrine function according to pancreatic resection portion. The aim of this study was to investigate the relation between pancreatic endocrine function and its parenchyma volume (PV) after pancreatectomy.

Methods:Patients undergoing pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) were recruited. The β-cell function and PVs were evaluated before and after pancreatectomy. Fasting C-peptide levels (F-CPR), stimulated C-peptide values (6min-CPR) and ΔCPR with glucagon stimulation test were used to assess β-cell function. ΔCPR was calculated on the basis of the formula ΔCPR = 6min-CPR minus F-CPR. The PVs were measured with 64-row multidetector computed tomography.

Results: A total of 47 patients (mean age 71±10 years; 18 female and 29 male; 29 patients with PD and 18 patients with DP) were enrolled. Median values of C-peptide levels with glucagon test and PV were significantly decreased after pancreatectomy (pre-operative vs. post-operative, P value. F-CPR: 1.8 vs. 1.4 ng/ml, P<0.001, 6min-CPR: 4.1 vs. 2.7 ng/ml, P<0.001, ΔCPR: 2.3 vs. 1.3 ng/ml, P<0.001 and PV: 48.1 vs. 19.1 cm3, P<0.001, respectively). Postoperative C-peptide levels were significantly correlated with postoperative PVs (post F-CPR: r=0.509, P<0.001, post 6min-CPR: r=0.641, P<0.001 and post ΔCPR: r=0.703, P<0.001, respectively). There were also significant correlations between postoperative C-peptide levels and postoperative PV according to pancreatectomy (PD; post F-CPR: r=0.444, P=0.018, post 6min-CPR: r=0.554, P=0.002 and post ΔCPR: r=0.612, P=0.001, respectively. DP; post F-CPR: r=0.542, P=0.020, post 6min-CPR: r=0.684, P=0.002 and post ΔCPR: r=0.751, P<0.001, respectively). Additionally, median value of postoperative C-peptide with glucagon stimulation test to postoperative PV ratios was not significantly different between patients with PD and DP.

Conclusions: Irrespective of resection portion, pancreatic endocrine function decreased with a PV. Postoperative pancreatic endocrine function depended on remaining PV.

Nothing to Disclose: TS, MY, TA, TS, KU, YM, SN

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