Multicenter prospective observational study of the patients who undergo total pancreatectomy

2022 Fiscal Year Final Research Report

• Project/Area Number: 18K08718
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: Kindai University
• Principal Investigator: Matsumoto Ippei 近畿大学, 医学部, 准教授 (30379408)
• Co-Investigator(Kenkyū-buntansha): 亀井 敬子 近畿大学, 医学部, 講師 (30411606) ; 竹山 宜典 近畿大学, 医学部, 教授 (70263374)
• Project Period (FY): 2018-04-01 – 2023-03-31
• Keywords: 膵全摘術 / 術後QOL / 膵性糖尿病 / 膵外分泌機能不全 / 術後脂肪肝

Outline of Final Research Achievements

A multicenter prospective observational study was conducted to assess quality of life (QOL), nutritional and blood control status, and nonalcoholic fatty liver disease after total pancreatectomy (TP). The study included 286 patients from 71 institutions in Japan.
QOL deteriorated in most components but improved mental health after TP. The occurrence rate of nonalcoholic fatty liver disease was 19.6%. Female and high BMI were identified as risk factors for nonalcoholic fatty liver disease after TP. Blood sugar levels were stable at 3 months after TP and HbA1c levels averaged at 7.0%-8.0% thereafter. Nutritional makers decreased at one month after TP and improved at 3 months after TP and thereafter. Body weight loss after TP more than or equal 0.3 kg and total cholesterol level <136 mg/dL at 6 months after TP and HbA1c less than or equal 8.9% and rapid-acting insulin use at 12 months after TP were independent risk factors for hypoglycemic events after TP.

Free Research Field

肝胆膵外科学

Academic Significance and Societal Importance of the Research Achievements

膵全摘術は、血糖コントロールの困難さによる重症糖尿病や膵外分泌機能不全による栄養障害がQOLの低下を招く術式と認識されている。しかし、膵全摘適応患者数はhigh volume centerでも年間数例であるため、多数例、前向き研究の報告はない。本研究は世界で初めての膵全摘術における多数例の前向き研究である。術前後のQOL、栄養指標、膵性糖尿病、術後脂肪肝について検討され、膵全摘術周術期の実態が高いエビデンスをもって示された極めて意義ある研究である。