TY - JOUR
T1 - New-onset diabetes after pancreatoduodenectomy: A systematic review and meta-analysis
AU - Scholten, Lianne
AU - Mungroop, Timothy H.
AU - Haijtink, Simone A. L.
AU - Issa, Yama
AU - van Rijssen, L. Bengt
AU - Koerkamp, Bas Groot
AU - van Eijck, Casper H.
AU - Busch, Olivier R.
AU - DeVries, J. Hans
AU - Besselink, Marc G.
PY - 2018
Y1 - 2018
N2 - Background: Pancreatoduodenectomy may lead to new-onset diabetes mellitus, also known as type 3c diabetes, but the exact risk of this complication is unknown. The aim of this review was to assess the risk of new-onset diabetes mellitus after pancreatoduodenectomy. Methods: A literature search was performed in PubMed, Embase (Ovid), and the Cochrane Library for English articles published from March 1993 until March 2017 (PROSPERO registry number: CRD42016039784). Studies reporting on the risk of new-onset diabetes mellitus after pancreatoduodenectomy were included. For meta-analysis, studies were pooled using the random-effects model. All studies were appraised according to the Newcastle-Ottawa Scale. Results: After screening 1,523 studies, 22 studies involving 1,121 patients were eligible. The mean weighted overall proportion of new-onset diabetes mellitus after pancreatoduodenectomy was 16% (95% confidence interval, 12%–20%). We found no significant difference in risk of new-onset diabetes mellitus when pancreatoduodenectomy was performed for nonmalignant disease after excluding patients with chronic pancreatitis (19% risk; 95% confidence interval, 7%–43%; 6 studies) or for malignant disease (22% risk; 95% confidence interval, 14%–32%; 11 studies), P =.71. Among all patients, 6% (95% confidence interval, 4%–10%) developed insulin-dependent new-onset diabetes mellitus. Conclusion: This systematic review identified a clinically relevant risk of new-onset diabetes mellitus after pancreatoduodenectomy of which patients should be informed preoperatively.
AB - Background: Pancreatoduodenectomy may lead to new-onset diabetes mellitus, also known as type 3c diabetes, but the exact risk of this complication is unknown. The aim of this review was to assess the risk of new-onset diabetes mellitus after pancreatoduodenectomy. Methods: A literature search was performed in PubMed, Embase (Ovid), and the Cochrane Library for English articles published from March 1993 until March 2017 (PROSPERO registry number: CRD42016039784). Studies reporting on the risk of new-onset diabetes mellitus after pancreatoduodenectomy were included. For meta-analysis, studies were pooled using the random-effects model. All studies were appraised according to the Newcastle-Ottawa Scale. Results: After screening 1,523 studies, 22 studies involving 1,121 patients were eligible. The mean weighted overall proportion of new-onset diabetes mellitus after pancreatoduodenectomy was 16% (95% confidence interval, 12%–20%). We found no significant difference in risk of new-onset diabetes mellitus when pancreatoduodenectomy was performed for nonmalignant disease after excluding patients with chronic pancreatitis (19% risk; 95% confidence interval, 7%–43%; 6 studies) or for malignant disease (22% risk; 95% confidence interval, 14%–32%; 11 studies), P =.71. Among all patients, 6% (95% confidence interval, 4%–10%) developed insulin-dependent new-onset diabetes mellitus. Conclusion: This systematic review identified a clinically relevant risk of new-onset diabetes mellitus after pancreatoduodenectomy of which patients should be informed preoperatively.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85047100889&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29779868
U2 - https://doi.org/10.1016/j.surg.2018.01.024
DO - https://doi.org/10.1016/j.surg.2018.01.024
M3 - Article
C2 - 29779868
SN - 0039-6060
VL - 164
SP - 6
EP - 16
JO - Surgery
JF - Surgery
IS - 1
ER -