Postoperative closed-loop glycemic control using an artificial pancreas in patients after esophagectomy

Aim: This study investigated the efficacy of an artificial pancreas in managing postoperative glycemic levels for patients after esophagectomy. Patients and Methods: We reviewed 107 patients with esophageal cancer who underwent esophagectomy, and had postoperative glucose management using the artificial pancreas. The target blood glucose level (TBGL) range was 90-140 mg/dl. Achievement rate of TBGL, total insulin use, number of severe hypoglycemic (<40 mg/dl) events, surgical complications and length of hospitalization (LOH) were evaluated. Results: Mean achievement rate of TBGL was 78.2%. Mean total insulin use was 47.9 units. Mean blood glucose level was 136.3 mg/dl (mean SD=20.7). The incidences of pneumonia, anastomotic leak, and surgical site infection were 11.2%, 12.1%, 23.4%, respectively. The mean LOH was 29.6 days. No patient developed severe hypoglycemia. Conclusion: Artificial pancreatic systems could minimize blood glucose variability and prevent severe hypoglycemic events for patients after esophagectomy.