docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2024-23-1-51-60docru-12Research ArticleОБЗОРЫREVIEWSСахарный диабет в исходе оперативных вмешательств на поджелудочной железеDiabetes Mellitus after Pancreatic Surgeryhttps://orcid.org/0000-0002-7936-7619АметовА. С.AmetovA. S.

Аметов Александр Сергеевич — д. м. н., профессор, заведующий кафедрой эндокринологии; ведущий научный сотрудник 

125993, г. Москва, ул. Баррикадная, д. 2/1, стр. 1

2/1 Barrikadnaya Str., build. 1, Moscow, 125993

5 2nd Botkinsky pr-d, Moscow, 125284

alexander.ametov@gmail.comhttps://orcid.org/0000-0003-1949-914XПашковаЕ. Ю.PashkovaE. Yu.

Пашкова Евгения Юрьевна — к. м. н., доцент кафедры эндокринологии; заведующая отделением эндокринологии 

125284, г. Москва, 2-й Боткинский пр-д, д. 5

2/1 Barrikadnaya Str., build. 1, Moscow, 125993

5 2nd Botkinsky pr-d, Moscow, 125284

parlodel@mail.ruhttps://orcid.org/0000-0003-4806-3935МитченкоЮ. И.MitchenkoYu. I.

Митченко Юлия Ивановна — младший научный сотрудник, врач отделения эндокринологии 

125284, г. Москва, 2-й Боткинский пр-д, д. 5

5 2nd Botkinsky pr-d, Moscow, 125284

yulyasha2647@gmail.comhttps://orcid.org/0000-0002-3920-5914АнцифероваД. М.AmikishievaK. A.

Анциферова Дарья Михайловна — аспирант кафедры эндокринологии; врач-эндокринолог

119034,  г. Москва, ул. Пречистенка, д. 37

2/1 Barrikadnaya Str., build. 1, Moscow, 125993

37 Prechistenka Str., Moscow, 119034

cifrenda@yandex.ruhttps://orcid.org/0000-0002-0879-5333АмикишиеваК. А.AmikishievaK. A.

Амикишиева Ксения Андреевна — аспирант кафедры эндокринологии; врач-эндокринолог 

125284,г. Москва, 2-й Боткинский пр-д, д. 5

2/1 Barrikadnaya Str., build. 1, Moscow, 125993

5 2nd Botkinsky pr-d, Moscow, 125284

isheryakova080795@mail.ruФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; ГБУЗ «Городская клиническая больница имени С.П. Боткина Департамента здравоохранения города Москвы»РоссияRussian Medical Academy of Continuous Professional Education; Botkin HospitalRussian FederationГБУЗ «Городская клиническая больница имени С.П. Боткина Департамента здравоохранения города Москвы»РоссияBotkin HospitalRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; ГБУЗ «Эндокринологический диспансер Департамента здравоохранения города Москвы»РоссияRussian Medical Academy of Continuous Professional Education; City Endocrinological DispensaryRussian Federation202412022025231ТЕРАПИЯ5160Copyright © Аметов А.С., Пашкова Е.Ю., Митченко Ю.И., Анциферова Д.М., Амикишиева К.А., 20252025Аметов А.С., Пашкова Е.Ю., Митченко Ю.И., Анциферова Д.М., Амикишиева К.А.Ametov A.S., Pashkova E.Y., Mitchenko Y.I., Amikishieva K.A., Amikishieva K.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/12Цель обзора

Цель обзора. Рассмотреть проблему патогенеза, диагностики и лечения сахарного диабета в исходе оперативных вмешательств на поджелудочной железе (ПЖ).

Основные положения

Основные положения. Сахарный диабет может развиваться вследствие других болезней, включая заболевания экзокринной части ПЖ. В настоящее время используется термин «сахарный Диабет в исходе заболеваний Экзокринной части Поджелудочной железы» (ДЭП). Одними из причин ДЭП являются операции на ПЖ. Панкреатэктомия подразделяется на два основных типа: тотальная панкреатэктомия и частичная, или резекция ПЖ. Частичная панкреатэктомия, в свою очередь, имеет два основных подтипа: резекция правой половины ПЖ — панкреатодуоденальная резекция (ПДР) и резекция левой половины ПЖ — дистальная резекция (ДР). При анализе данных литературы отчетливо видно, что проблема метаболических исходов ПДР и ДР активно изучается и представляет большой интерес. Несмотря на примерно равный объем резецированной ткани, при ДР чаще и раньше возникает сахарный диабет, при ПДР же возможна ремиссия ранее существовавшего диабета у существенного количества пациентов. В отношении экзокринной функции ситуация обратная — после ПДР вероятность развития экзокринной недостаточности ПЖ выше, чем после ДР.

Заключение

Заключение. При изучении данных литературы становится очевидно, что существует насущная необходимость в разработке подходов к раннему назначению комбинированной терапии описанной категории больных с акцентом на одновременную коррекцию экзо- и эндокринной функций ПЖ.

Aim

Aim. To highlight the problem of pathogenesis, diagnostics and treatment of diabetes mellitus in the outcome of surgical interventions on the pancreas.

Key points

Key points. Diabetes mellitus can develop as a result of different diseases, including diseases of the exocrine part of the pancreas. Currently, the term “Diabetes of the Exocrine Pancreas” (DEP) is used. One of the causes of DEP is pancreatic surgery. Pancreatectomy is divided into two main types: total pancreatectomy and partial or pancreatic resection. Partial pancreatectomy, in turn, has two main subtypes: resection of the right half of the pancreas — pancreatoduodenal resection (PDR) and resection of the left half of the pancreas — distal resection (DR). When analyzing the literature data, it is clearly seen that the problem of metabolic outcomes of PDR and others is actively studied and is of great interest. Despite the approximately equal volume of resected tissue, diabetes mellitus occurs more often and earlier after DR, while after PDR, remission of pre-existing diabetes is possible in a significant number of patients. With regard to exocrine function, the situation is reversed — after PDR, the probability of developing exocrine pancreatic insufficiency is higher than after DR.

Conclusion

Conclusion. When studying the literature data, it becomes obvious that there is an urgent necessity to develop approaches to the early combination therapy in patients after pancreatic surgery with simultaneous correction of exo- and endocrine pancreatic.

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The authors declare that there are no conflicts of interest present.