Work

Impact of diabetes mellitus on postoperative complications in patients undergoing pancreatic surgery

Year: 2024

Type: article

Abstract: Background Enhanced Recovery After Surgery (ERAS) protocols decrease postoperative complications, but data on their effect on diabetic patients undergoing pancreatectomy are scarce. This study assessed whether diabetes mellitus (DM) was a morbidity predictor after pancreatectomy within an ERAS program. Methods A cross-sectional study including all patients who underwent pancreatectomy (2012–2022) and followed an ERAS pathway was performed. Multivariable analysis was used to determine whether DM was a morbidity predictor. Association between ERAS compliance and morbidity rate was assessed. Results A total of 558 patients were included (266 women, median age 66, median body-mass index 25). Most patients underwent open pancreatoduodenectomy ( n =369, 66%). In diabetic patients with overall ERAS compliance ≤ 60 %, morbidity was 38/40 (95%), whereas in diabetic patients with overall ERAS compliance>60 %, it decreased to 37/50 (74%, p =0.008). DM was not found as an independent complication predictor (OR 0.7, 95%CI 0.4–1.2, p =0.186), while body-mass index>25 kg/m 2 and preoperative biliary stenting were preoperative morbidity predictors (OR 1.1, 95%CI 1.0–1.1, p =0.049; OR 1.7, 95%CI 1.0–2.5, p =0.044). Conclusion This study showed that DM was not associated with postoperative complications after pancreatectomy within an ERAS program. It highlighted the importance of a good ERAS compliance to decrease the risk of postoperative complications in DM patients.

Source: HPB

DOI: 10.1016/j.hpb.2024.12.020