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This research aimed to evaluate the incidence of postoperative diabetes and exocrine insufficiency following two surgical techniques in patients with benign pancreatic tumors.

January 16, 2026Journal of the American College of Surgeons0 citations

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Incidence of Endocrine and Exocrine Pancreatic Insufficiency After Minimally Invasive Parenchyma-Sparing Pancreatectomy

DSDario SolinasUniversity of Verona MMMarco Dal MolinJohns Hopkins University BCBrady A. CampbellJohns Hopkins University

Key Points

This research aimed to evaluate the incidence of postoperative diabetes and exocrine insufficiency following two surgical techniques in patients with benign pancreatic tumors.
Retrospective single-institution analysis from 2006 to 2024
Propensity score matching (1:1) to compare MI-PSP and MI-P
Assessment of postoperative complications using multivariable regression
23% of MI-P patients developed new-onset or worsening diabetes versus 9.8% in MI-PSP patients.
Insulin treatment was required for 12% of MI-P patients compared to 3.3% of MI-PSP patients.
Five-year cumulative incidence risk for diabetes was 38.9% in MI-P vs. 26.7% in MI-PSP (p=0.008).
PEI occurred in 22% of MI-P versus 5.4% of MI-PSP patients (p=0.001).
Higher risk for diabetes (HR 3.06) and PEI (OR 3.18) in MI-P patients.

Abstract

Background: Minimally invasive parenchyma-sparing pancreatectomy (MI-PSP) is being increasingly adopted for benign and low-grade pancreatic tumors. We sought to evaluate if this approach is associated with reduced incidence of postoperative diabetes mellitus (DM) and pancreatic exocrine insufficiency (PEI). Study Design: We conducted a retrospective single-institution analysis of patients undergoing minimally invasive pancreatectomy between 2006 and 2024 for benign and low-grade pancreatic tumors, defined as localized neoplasms with a low risk of metastases. Propensity score matching (1:1) was performed to compare MI-PSP and minimally invasive standard pancreatectomy (MI-P) based on age, gender, BMI, preoperative non-insulin-dependent diabetes mellitus, and tumor size. The risk of developing postoperative new-onset or worsening DM and PEI was assessed using a multivariable regression model. Results: A total of 184 patients were included. No significant difference emerged between the two groups regarding postoperative complications (Clavien-Dindo ≥ 3) within 90 days (p=0.7). Among patients undergoing MI-P, 21 (23%) developed new-onset or worsening diabetes, with 11 (12%) requiring insulin. In contrast, among patients undergoing MI-PSP, only 9 (9.8%) developed new-onset or worsening diabetes, with 3 (3.3%) needing insulin treatment. The five-year cumulative incidence risk of developing new-onset or worsening diabetes was 38.9% (95% CI, 20.7-52.9) in the MI-P group and 26.7% (95% CI, 7.5-42) in the MI-PSP group (p=0.008). Similarly, PEI developed in 22% of MI-P versus 5.4% of MI-PSP patients (p=0.001). In the multivariable analysis, patients undergoing MI-P exhibited a significantly higher risk of developing new-onset or worsening diabetes (HR 3.06, p=0.006) and PEI (OR 3.18, p=0.037) compared to those receiving MI-PSP. Conclusions: MI-PSP was associated with a lower incidence of postoperative metabolic complications in the management of benign and low-grade pancreatic tumors.

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Solinas et al. (Wed,) studied this question.

synapsesocial.com/papers/6969d4a2940543b9777098f3 https://doi.org/https://doi.org/10.1097/xcs.0000000000001758

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