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Abstract
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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Details
1 Gangnam Severance Hospital, Yonsei University College of Medicine, Pancreatobiliary Cancer Clinic, Department of Surgery, Seoul, Republic of Korea (GRID:grid.459553.b) (ISNI:0000 0004 0647 8021)
2 Yonsei University College of Medicine, Department of Internal Medicine, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
3 Severance Institute for Vascular and Metabolic Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Department of Internal Medicine, Seoul, Korea (GRID:grid.459553.b) (ISNI:0000 0004 0647 8021)
4 Gangnam Severance Hospital, Yonsei University College of Medicine, Department of Pathology, Seoul, Republic of Korea (GRID:grid.459553.b) (ISNI:0000 0004 0647 8021)