New-onset diabetes after pancreatoduodenectomy: A systematic review and meta-analysis
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.
|Persistent URL||dx.doi.org/10.1016/j.surg.2018.01.024, hdl.handle.net/1765/106508|
Scholten, L. (Lianne), Mungroop, T.H. (Timothy H.), Haijtink, S.A.L. (Simone A.L.), Issa, Y, van Rijssen, L.B, Groot Koerkamp, B, … Besselink, M.G. (2018). New-onset diabetes after pancreatoduodenectomy: A systematic review and meta-analysis. Surgery. doi:10.1016/j.surg.2018.01.024