review of literature on clinical pancreatology - The Pancreapedia

closure was associated with small serosal adhesions, but no gross abscess or necrosis.Thus, there was no clinical or survival difference between NOTES and laparoscopicapproaches [512].Renal function at pancreatoduodenectomyA retrospective study was conducted to compare measured creatinine clearance (Ccr) withestimated glomerular filtration rate (eGFR) as a preoperative renal function test in patientsundergoing pancreatoduodenectomy. The records <strong>of</strong> 139 patients undergoingpancreatoduodenectomy were enrolled, and preoperative Ccr, a 3-variable equation foreGFR (eGFR3) and a 5-variable equation for eGFR (eGFR5) were estimated. The maximumincreases in the postoperative serum creatinine and urea nitrogen levels were comparedbetween the groups with normal and abnormal levels relative to Ccr, eGFR3, and eGFR5.There were 30 patients with abnormal Ccr levels, 17 with abnormal eGFR3 levels, and 16with abnormal eGFR5 levels. Postoperative serum creatinine and urea nitrogen levels weresignificantly higher in patients with eGFR3 and eGFR5 abnormal levels than in patients witheGFR3 and eGFR5 normal levels. Postoperative serum creatinine and urea nitrogen levelstended to be higher in patients with Ccr abnormal level. The sensitivity and specificity <strong>of</strong>eGFR3 and eGFR5 for postoperative renal dysfunction were better than those <strong>of</strong> Ccr, andmultivariate analysis showed that eGFR5 was the only independent predictive factor forpostoperative renal dysfunction. Thus means that the eGFR5 and eGFR3, rather than thecreatinine clearence, are recommended as preoperative renal function test in patientsundergoing pancreatoduodenectomy [513].Glucose monitoringPeroperativelyTo evaluate a closed-loop system providing continuous monitoring and strict control <strong>of</strong>perioperative blood glucose following pancreatic resection it was performed a prospective,randomized clinical trial in 30 patients who had pancreatic resection for pancreatic neoplasm.Perioperative blood glucose levels were continuously monitored using an artificial endocrinepancreas (STG-22). Glucose levels were controlled using either the sliding scale method(sliding scale group, n=13) or the artificial pancreas (artificial pancreas group, n=17).Incidence <strong>of</strong> severe hypoglycemia (