ABSTRACT
Objective To explore the correlation between blood glucose and postoperative recovery of pancreatic cancer patients with diabetes.Methods According to the level of glycemic control after operation,68 cases of pancreatic cancer patients with diabetes were divided into two groups,including 34 cases of intensive control group (blood glucose 4.4 ～ 6.1 mol/L),34 cases of control group (blood glucose 6.1 ～11.1 mol/L).Fasting blood glucose (FBG),fasting insulin (FINS) and C reaction protein (CRP) in all patients were detected at 1st,3rd and 7th day after operation,and the recovery condition,postoperative complications and other clinical data were compared and analyzed.Results FBG,FINS and CRP in intensive control group were (6.94 ± 0.94) mmol/L,(17.38 ± 7.37) mmol/L,(108.33 ± 37.25) mg/L,and in control group were (7.81 ± 1.36) mmol/L,(23.73 ± 8.25) mmol/L,(131.51 ± 42.34) mg/L at 3rd day after operation.There were significant difference in serum FBG,FINS and CRP level between the two groups at 3rd day after operation (P ＜ 0.05).Compared with control group,postoperative duration of fever [(1.4 ± 0.8) vs (2.5 ± 1.1) d],duration of antibiotics [(3.1 ± 0.7) vs (4.6 ± 0.8) d] and time of anal exhaust [(2.5 ±0.5) vs 93.7 ± 0.8)d] in intensive group were significantly reduced (P ＜ 0.05).The wound infection rate in intensive control group was significantly decreased (5.9％ vs 23.5％,P ＜0.05),the rate of mortality and other postoperative complications between the two groups was not statistically significant (P＞0.05).Conclusions Intensive glycemic control can contribute to improve insulin resistance,reduce inflammation reaction and improve the prognosis of postoperative pancreatic cancer patients with diabetes,and it does not increase the postoperative complication rate.
ABSTRACT
Objective To investigate the timing of surgical operation and prognosis of patients with severe biliary pancreatitis (SBP).Methods The patients were classified into three groups according to the interval between disease onset and operation time ( ＜7 d, 7 ～ 14 d, ＞ 14 d).The incidence of complications and mortality were compared among the 3 groups.Results A total of 32 patients of acute pancreatitis due to biliary tract diseases between 2006 and 2009 were included, and there were 15 males and 17 females with a median age of 51 years old.9 patients received operation within 7 days of disease onset and all of these patients were complicated with biliary obstruction;12 patients received operation between 7 ～ 14 days of disease onset and all of these patients were non-respondent to early non-operative management.11 patients received operation after 14 days.The complication rates in the three groups were 44.4% , 50.0% and 45.5%, respectively, the difference was not statistically significant ( P ＞ 0.05 ).The mortality rates in the three groups were 11.1%,16.7% and 18.2%, respectively, and the difference was not statistically significant ( P ＞ 0.05 ).Conclusions The management of SBP should be individualized.Patients with biliary obstruction, suppurative cholangitis or non-respondent to early non-operative management shall be managed surgically, and this is critical to decrease the mortality rates and improve prognosis.