Effect of three kinds of digestive tract reconstruction on postoperative blood glucose and complications in patients with gastric cancer complicated with type 2 diabetes

Abstract:

Objective：To observe the effect of 3 kinds of digestive tract reconstruction on postoperative blood glucose and complica－tions in patients with gastric cancer（GC） combined with type 2 diabetes，who received radical gastrectomy. Methods：Forty-seven gas－tric cancer patients with type 2 diabetes who received routine open gastrectomy in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed from January 2003 to October 2012. The 47 patients were grouped into Billroth Ⅰ（Group A，n=12），Billroth Ⅱ（Group B，n=20） and Roux-en-Y group（Group C，n=15）. Fasting plasma glucose（FPG） and 2-hour plasma glucose（2hPG） before the operative and at 1 week，2 weeks，1 month and 3 months after the operation were recorded and compared among different groups. Meanwhile postoperative complications in the three groups were observed during the hospitalization. Results：There were statistically significant differences in FPG before the operation and at 1 month and 3 months after the operation（P<0.01）. There were statistically significant differences in 2hPG before the operation and at 1 week，2 weeks，1 month and 3 months after the operation（P<0.01）. Remission rate of DM2 was 30.00%，77.78% and 84.62% in group A，B，and C，respectively. Incidence of postop－erative complications was 41.67%，50.00% and 33.33% in group A，B，and C，respectively. Overall incidence of postoperative compli－cations was 42.55%，and the main complication was pulmonary infection（19.15%）. Conclusions：Among the three digestive tract re－constructions（Billroth Ⅰ，Billroth Ⅱ and Roux-en-Y） in radi－cal gastrectomy for patients with GC complicated with DM2，Billroth Ⅱ and Roux-en-Y can improve the blood glucose lev－els efficiently，and Roux-en-Y is the most efficient.