Total pancreatectomy with islet cell autotransplantation as the initial treatment for minimal-change chronic pancreatitis |
| |
Authors: | Gregory C Wilson Jeffrey M Sutton Milton T Smith Nathan Schmulewitz Marzieh Salehi Kyuran A Choe John E Brunner Daniel E Abbott Jeffrey J Sussman Syed A Ahmad |
| |
Institution: | 1. Department of Surgery, University of Cincinnati Pancreatic Disease Center, University of Cincinnati College of Medicine,Cincinnati, OH, USA;2. Department of Gastroenterology, University of Cincinnati Pancreatic Disease Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA;3. Department of Endocrinology, University of Cincinnati Pancreatic Disease Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA;4. Department of Radiology, University of Cincinnati Pancreatic Disease Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA |
| |
Abstract: | ObjectivesPatients with minimal-change chronic pancreatitis (MCCP) are traditionally managed medically with poor results. This study was conducted to review outcomes following total pancreatectomy with islet cell autotransplantation (TP/IAT) as the initial surgical procedure in the treatment of MCCP.MethodsAll patients submitted to TP/IAT for MCCP were identified for inclusion in a single-centre observational study. A retrospective chart review was performed to identify pertinent preoperative, perioperative and postoperative data.ResultsA total of 84 patients with a mean age of 36.5 years (range: 15–60 years) underwent TP/IAT as the initial treatment for MCCP. The most common aetiology of chronic pancreatitis in this cohort was idiopathic (69.0%, n = 58), followed by aetiologies associated with genetic mutations (16.7%, n = 14), pancreatic divisum (9.5%, n = 8), and alcohol (4.8%, n = 4). The most common genetic mutations pertained to CFTR (n = 9), SPINK1 (n = 3) and PRSS1 (n = 2). Mean ± standard error of the mean preoperative narcotic requirements were 129.3 ± 18.7 morphine-equivalent milligrams (MEQ)/day. Overall, 58.3% (n = 49) of patients achieved narcotic independence and the remaining patients required 59.4 ± 10.6 MEQ/day (P < 0.05). Postoperative insulin independence was achieved by 36.9% (n = 31) of patients. The Short-Form 36-Item Health Survey administered postoperatively demonstrated improvement in all tested quality of life subscales.ConclusionsThe present report represents one of the largest series demonstrating the benefits of TP/IAT in the subset of patients with MCCP. |
| |
Keywords: | |
本文献已被 ScienceDirect 等数据库收录! |
|