@article{oai:shiga-med.repo.nii.ac.jp:00003483,
 author = {赤堀, 浩也 and 谷, 眞至 and 北村, 直美 and 前平, 博充 and 今宿, 康彦 and 辻田, 靖之 and 清水, 智治 and 北川, 裕利 and 江口, 豊 and 赤堀, 浩也 and TANI, Masaji and KITAMURA, Naomi and MAEHIRA, Hiromitsu and IMASHUKU, Yasuhiko and TSUJITA, Yasuyuki and SHIMIZU, Tomoharu and KITAGAWA, Hirotoshi and EGUCHI, Yutaka},
 journal = {American journal of surgery},
 month = {Dec},
 note = {BACKGROUND:We sought to investigate the efficacy of perioperative tight glycemic control (TGC) in reducing of postoperative infectious complications (POICs) and study its impact on early inflammatory mediators in patients who underwent pancreaticoduodenectomy., METHODS:In this non-randomized trial, the artificial pancreas (AP) group received TGC (target glucose range of 80-110 mg/dL; n = 14), while the control group received conventional glycemic control (range of 80-180 mg/dL; n = 15). The primary endpoint was POICs., RESULTS:The AP group had a markedly decreased POIC rate (28.6% vs. 73.3%; P = 0.027), mean glycemic variability (13.5 ± 3.5% vs. 16.4 ± 5.9%; P = 0.038), and plasma interleukin-6 level (26.3 ± 33.8 vs 98.3 ± 89.1 pg/ml; P = 0.036) compared to the control group, but insulin dosage (27.0 ± 13.4 vs. 10.2 ± 16.2 U; P = 0.002) and the adiponectin ratio (i.e., postoperative/preoperative adiponectin; 0.8 ± 0.2 vs. 0.6 ± 0.3; P = 0.021) were markedly higher in the AP group., CONCLUSIONS:Among patients undergoing PD with impaired glucose tolerance, AP facilitated strict glycemic control and resulted in a reduction of anti-inflammatory mediators and POICs., SUMMARY:Perioperative hyperglycemia increases postoperative infectious complications; however, tight glycemic control using artificial pancreas can reduce them via a dual effect. Artificial pancreas facilitates strict and safe glycemic control while reducing anti-inflammatory mediators, including adiponectin, following pancreaticoduodenectomy., Journal Article},
 title = {Perioperative tight glycemic control using artificial pancreas decreases infectious complications via suppression of inflammatory cytokines in patients who underwent pancreaticoduodenectomy: A prospective, non-randomized clinical trial.},
 year = {2019}
}