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Postoperative Closed-loop Glycemic Control Using an Artificial Pancreas in Patients After Esophagectomy
Hiroyuki Kitagawa1, Tomoaki Yatabe2, Tsutomu Namikawa3
1Department of Surgery, Kochi Medical School, Nankoku, Japan.
Aim:
This study investigated the efficacy of an artificial pancreas in managing postoperative glycemic levels for patients after esophagectomy.
Patients And Methods:
We reviewed 107 patients with esophageal cancer who underwent esophagectomy, and had postoperative glucose management using the artificial pancreas. The target blood glucose level (TBGL) range was 90-140 mg/dl. Achievement rate of TBGL, total insulin use, number of severe hypoglycemic (<40 mg/dl) events, surgical complications and length of hospitalization (LOH) were evaluated.
Results:
Mean achievement rate of TBGL was 78.2%. Mean total insulin use was 47.9 units. Mean blood glucose level was 136.3 mg/dl (mean SD=20.7). The incidences of pneumonia, anastomotic leak, and surgical site infection were 11.2%, 12.1%, 23.4%, respectively. The mean LOH was 29.6 days. No patient developed severe hypoglycemia.
Conclusion:
Artificial pancreatic systems could minimize blood glucose variability and prevent severe hypoglycemic events for patients after esophagectomy.
