Table of Contents
HPB Surgery
Volume 2012, Article ID 381328, 8 pages
Research Article

Glycemic Control after Total Pancreatectomy for Intraductal Papillary Mucinous Neoplasm: An Exploratory Study

1Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL 32224, USA
2Division of Endocrinology, Mayo Clinic, Jacksonville, FL 32224, USA
3Department of Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
4Biostatistics Unit, Mayo Clinic, Jacksonville, FL 32224, USA
5Department of Transplantation, Mayo Clinic, Jacksonville, FL 32224, USA

Received 30 April 2012; Accepted 3 July 2012

Academic Editor: Christos G. Dervenis

Copyright © 2012 Laith H. Jamil et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Glycemic control following total pancreatectomy (TP) has been thought to be difficult to manage. Diffuse intraductal papillary mucinous neoplasm (IPMN) is a potentially curable precursor to pancreatic adenocarcinoma, best treated by TP. Objective. Compare glycemic control in patients undergoing TP for IPMN to patients with type 1 diabetes mellitus (DM). Design/Setting. Retrospective cohort. Outcome Measure. Hemoglobin A1C(HbA1C) at 6, 12, 18, and 24 months after TP. In the control group, baseline was defined as 6 months prior to the first HbA1c measure. Results. Mean HgbA1C at each point of interest was similar between TP and type I DM patients (6 months (7.5% versus 7.7%, 𝑃 = 0 . 5 2 ), 12 months (7.3% versus 8.0%, 𝑃 = 0 . 0 8 1 ), 18 months (7.7% and 7.6%, 𝑃 = 0 . 6 4 ), and at 24 months (7.3% versus 7.8%, 𝑃 = 0 . 1 0 )). Seven TP patients (50%) experienced a hypoglycemic event compared to 65 type 1 DM patients (65%, 𝑃 = 0 . 3 8 ). Limitations. Small number of TP patients, retrospective design, lack of long-termfollowup. Conclusion. This suggests that glycemic control following TP for IPMNcan be well managed, similar to type 1 DM patients. Fear of DM following TP for IPMN should not preclude surgery when TP is indicated.