Analysis Of Factors Influencing The Recovery Of Rebound Hyperglycemia After Insulinoma Surgery

Background:Insulinoma is a rare form of neuroendocrine tumor.Surgical resection is the preferred treatment,and it is currently the only possible cure.As insulinoma continuously secretes a large amount of insulin causing hyperinsulinemia,it inhibits the secretion of normal pancreatic cells while causing hypoglycemia.After insulinoma surgery,because the pancreas function is not completely restored,the patient tends to exhibit postoperative hyperglycemia.With the pancreatic?cell function returning to normal in 3 weeks,insulin secretion increased,and blood glucose gradually returned to normal level.However,there are some differences in the time for recovery of rebound hyperglycemia between different patients.Objective:Analyze the factors that affect the recovery time of rebound hyperglycemia after insulinoma surgery.Methods:Eighty-seven patients with insulinoma treated at the Hepatobiliary and Pancreatic Surgery Department of the First Affiliated Hospital of Zhengzhou University from July 2011 to November 2017 were reviewed.Count data were measured using absolute value and rate,using X~2 test;measurement data using?X±S;single-factor K-M analysis of blood glucose recovery after surgery,and multifactor COX proportional hazards regression analysis,P<0.05 was considered statistically significance.The above data uses SPSS 21.0 for related data analysis.Result:1.There're 37 males and 48 females,with a male to female ratio of 1:1.3;The age range of those patient is 11 to 75 years,and the average age is 48.7 years;90.8%of the patient is the single tumor,9.2%of the patient is the multi-nodulose tumor.There were 22 patients whose tumor diameter was less than or equal to 10 mm,and59 patients diameter was greater than 10 mm and less than 20 mm,and 13 patients diameter was greater than 20 mm.The average tumor size was 14.8 mm.There were37 patients are G1 tumor stage and 48 patients are G2 tumor stage.Surgical methods:67 patients underwent insulinoma resection,and 18 patients underwent pancreatic body resection.2.All patients showed postoperative rebound hyperglycemia,and all patients with rebound hyperglycemia returned to normal within 3 weeks.3.The results of univariate K-M analysis showed that surgical methods(P=0.001),gender(P=0.002)and tumor size(P<0.001)were factors influencing the recovery time of postoperative hyperglycemia.4.Multivariate COX proportional-regression analysis results showed that surgical methods(P<0.001),tumor size(P=0.020),and gender(P=0.016)were factors influencing the recovery time of postoperative hyperglycemia.Conclusion:1.Gender may be factors that affect the recovery time of postoperative rebound hyperglycemia,women recover faster than men.2.Tumor size may be factors that affect the recovery time of postoperative rebound hyperglycemia.The smaller the tumor,the shorter the recover time;3.Surgical methods may be factors that affect the recovery time of postoperative rebound hyperglycemia.Patients with insulinoma resection have a shaort recovery time;...