Completion pancreatectomy reduces severe endocrine complications compared to total pancreatectomy.

• Total pancreatectomy patients face a 2.9-fold increase in endocrine issues during the first year post-surgery.
• Risk of hypoglycemia is 3.0 times higher, while diabetic ketoacidosis risk is 9.3 times greater in total pancreatectomy patients.

Surgeons should consider completion pancreatectomy for better endocrine outcomes and enhance patient monitoring and education.

• Analysis showed earlier and more frequent hypoglycemic events in total pancreatectomy patients.