Postoperative Blood Glucose Management After Total Pancreatectomy Combined With Total Gastrectomy And Autologous Small Intestine Transplantation.

Total pancreatectomy and total gastrectomy combined with autologous small intestine transplantation is a rarely reported surgical approach in the treatment of pancreatic cancer. This article summarizes the nursing experience of blood glucose management in a patient who underwent total pancreatectomy, total gastrectomy, and autologous small intestine transplantation. Because of marked postoperative glycemic instability and impaired intestinal absorption, personalized blood glucose management targets and proactive insulin pump therapy were implemented to address the unique characteristics of postoperative blood glucose metabolism and the effect of associated complications on blood glucose levels. Additionally, family involvement in diarrhea and dietary management, as well as comprehensive follow-up care after discharge, were integrated. Postoperatively, the patient did not experience ketoacidosis or severe hypoglycemia, with a coefficient of variation (CV) ranging from 24.5% to 31.2%. The patient recovered and was discharged on postoperative day (POD) 68. One year of follow-up revealed stable blood glucose levels without severe hypoglycemia or hyperglycemia.