Previous studies have shown that total
pancreatectomy with islet cell
autotransplantation improves quality of life in
chronic pancreatitis. A significant number of these patients develop postoperative
hyperglycemia and daily
insulin requirements or increase in daily
insulin requirements. Our study investigates whether increased
insulin requirements postoperatively have a negative impact on quality of life. A prospectively collected database of 74 patients undergoing extensive
pancreatectomy with islet
autotransplantation for
pancreatitis was reviewed. Data pertaining to daily requirements and quality of life (QOL), as measured by the SF-12 questionnaire, in the preoperative and postoperative period were reviewed. Approval from the Institutional Review Board for the evaluation of human subjects was obtained. Seventy-four patients underwent extensive
pancreatectomy with islet
autotransplantation for
pancreatitis. The majority of these patients required new daily
insulin or an increase in daily
insulin requirements postoperatively. Mean preoperative HA1c in this group was 5.6 with an increase to 7.3 at 6 months postoperatively (P < 0.001), a mean of 8.1 at 12 months, and 8.9 at 2 years. Mean preoperative daily
insulin requirements for this group were five units/day with average increase to 19 units/day at 6 months, 21 units/day at 12 months, and 26 units/day at 2 years. Preoperative QOL scores were a mean of 26 for the physical component and 36 for the mental health component. Postoperatively, physical component scores averaged 33 at 6 months (p < 0.001), 36 at 12 months, and 36 at 2 years; the mental health component scores averaged 42 at 6 months (p = 0.007), 41 at 12 months, and 41 at 2 years. There is no correlation between physical component score or mental component score QOL scores and daily
insulin requirements (r = -0.016 and r = 0.039, respectively). Total
pancreatectomy with islet cell
autotransplantation is an effective surgery for end-stage
chronic pancreatitis. Quality of life significantly improves in physical and mental health components regardless of a postoperative increase in daily
insulin requirements.