| Outcomes and quality of life after partial pancreatectomy for noninsulinoma pancreatogenous hypoglycemia from diffuse islet cell disease. | |
| | |
MedLine Citation:
|
PMID: 21134557 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Noninsulinoma pancreatogenous hypoglycemia (NIPH) is a rare cause of hypoglycemia, especially affecting postbariatric surgery patients, related to excessive insulin secretion. Partial pancreatectomy controls hypoglycemia in the early postoperative period; however, multiple patients have experienced symptomatic relapse. The study goal was to assess frequency and severity of recurrent symptoms in operated patients. METHODS: All patients who underwent pancreatic resection for NIPH at Mayo Clinic from January 1996 through December 2008 were reviewed for demographics, preoperative testing, operative and postoperative details. Data from patient records, mail survey, European Quality of Life Survey (EQ-5D), and Fear of Hypoglycemia Scale (FOHS) were used to assess outcome. RESULTS: Seventy-five patients underwent pancreatic resection for NIPH (5 dead, 1 incarcerated). 48 patients (70%) completed the survey; mean follow-up, 53 months. Median time to recurrent symptoms was 16 months in 41 patients (87%). Despite symptom recurrence, 36 patients (75%) reported overall improvement in symptoms and quality of life (QOL); median EQ-5D health scores increased from 40 to 75 out of 100 (P < .001). Moreover, they reported marked reduction in psychologic stress and hypoglycemic symptoms with greater than 50% decrease in FOHS overall, worry, and behavioral median scores (P < .001). Overall, half of the patients were classified as highly/moderately surgically successful, whereas the other half was minimally successful or surgical failures. CONCLUSION: Although nearly 90% of NIPH patients reported recurrent symptoms suggestive of hypoglycemia, a majority reported improvements in QOL and marked reduction in other symptoms after pancreatic resection. Nevertheless, 25% of patients experienced no benefit from partial pancreatectomy. |
| | |
Authors:
|
Kimberly A Vanderveen; Clive S Grant; Geoffrey B Thompson; David R Farley; Melanie L Richards; Adrian Vella; Brenda Vollrath; F John Service |
Related Documents
:
|
17657377 - Ambulatory thyroid surgery: an audit of safety and outcomes. 15665067 - Waiting for orthopaedic surgery: factors associated with waiting times and patients' op... 22527927 - Saving time stitching thick biological mesh during laparoscopic ventral rectopexy. 21515207 - Thoracoscopic resection of mediastinal bronchogenic cysts in adults. 21088857 - A comparison of surgical outcomes between endoscopic and robotically assisted thyroidec... 18824497 - Pitfalls in the diagnosis and management of obstructive uterovaginal duplication: a ser... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Surgery Volume: 148 ISSN: 1532-7361 ISO Abbreviation: Surgery Publication Date: 2010 Dec |
Date Detail:
|
Created Date: 2010-12-07 Completed Date: 2011-01-14 Revised Date: 2013-01-21 |
Medline Journal Info:
|
Nlm Unique ID: 0417347 Medline TA: Surgery Country: United States |
Other Details:
|
Languages: eng Pagination: 1237-45; discussion 1245-6 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright © 2010 Mosby, Inc. All rights reserved. |
Affiliation:
|
Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Fear Female Follow-Up Studies Health Status Humans Hypoglycemia / etiology, psychology, surgery* Islets of Langerhans / surgery* Male Middle Aged Pancreatectomy / methods*, psychology Pancreatic Diseases / surgery* Postoperative Complications / epidemiology Quality of Life* Recurrence Retrospective Studies Splenectomy / methods, psychology Time Factors Treatment Failure Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
|
R01 DK082396/DK/NIDDK NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A novel RET inhibitor with potent efficacy against medullary thyroid cancer in vivo.
Next Document: Better preservation of endocrine function after central versus distal pancreatectomy for mid-gland l...