Pancreatic surgery and tertiary pancreatitis services warrant provision for support from a specialist diabetes team  

作　　者：Vasileios K Mavroeidis Jennifer Knapton Francesca Saffioti Daniel L Morganstein 

机构地区：[1]Department of HPB Surgery,Bristol Royal Infirmary,University Hospitals Bristol and Weston NHS Foundation Trust,Bristol BS28HW,United Kingdom [2]Department of Gastrointestinal Surgery,Southmead Hospital,North Bristol NHS Trust,Bristol BS105NB,United Kingdom [3]Department of Academic Surgery,Royal Marsden NHS Foundation Trust,London SW36JJ,United Kingdom [4]Department of Gastroenterology and Hepatology,Oxford University Hospitals NHS Foundation Trust,Oxford OX39DU,United Kingdom [5]UCL Institute for Liver and Digestive Health,University College London,London NW32PF,United Kingdom [6]Department of Endocrinology,Chelsea and Westminster Hospital NHS Foundation Trust,London SW109NH,United Kingdom [7]Department of Gastrointestinal Unit,Royal Marsden NHS Foundation Trust,London SW36JJ,United Kingdom

出　　处：《World Journal of Diabetes》2024年第4期598-605,共8页世界糖尿病杂志（英文版）（电子版）

摘　　要：Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic pancreatitis.The centralisation of pancreatic surgery services,with the development of designated large-volume centres,has contribu-ted to significantly improved outcomes.In this editorial,we discuss the complex associations between diabetes mellitus(DM)and pancreatic/periampullary disease in the context of pancreatic surgery and overall management of complex pancreatitis,highlighting the consequential needs and the indispensable role of specialist diabetes teams in support of tertiary pancreatic services.Type 3c pan-creatogenic DM,refers to DM developing in the setting of exocrine pancreatic disease,and its identification and management can be challenging,while the glycaemic control of such patients may affect their course of treatment and outcome.Adequate preoperative diabetes assessment is warranted to aid identification of patients who are likely to need commencement or escalation of glucose lowering therapy in the postoperative period.The incidence of new onset diabetes after pancreatic resection is widely variable in the literature,and depends on the type and extent of pancreatic resection,as is the case with pancreatic parenchymal loss in the context of severe pancreatitis.Early involvement of a specialist diabetes team is essential to ensure a holistic management.In the current era,large volume pancreatic surgery services commonly abide by the principles of enhanced recovery after surgery,with inclusion of provisions for optimisation of the perioperative glycaemic control,to improve outcomes.While various guidelines are available to aid perioperative management of DM,auditing and quality improvement platforms have highlighted deficiencies in the perioperative management of diabetic patients and areas of required improvement.The need for perioperative support of diabetic patients by specialist diabetes teams is uniform

关 键 词：PANCREATECTOMY PANCREATODUODENECTOMY Whipple’s PANCREATITIS Diabetes specialist Type 3c pancreatogenic diabetes mellitus 

分 类 号：R977.15[医药卫生—药品]