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Morbidity of total pancreatectomy with islet cell auto-transplantation compared to total pancreatectomy alone.

AbstractBACKGROUND:
In pancreatitis, total pancreatectomy (TP) is an effective treatment for refractory pain. Islet cell auto-transplantation (IAT) may mitigate resulting endocrinopathy. Short-term morbidity data for TP + IAT and comparisons with TP are limited.
METHODS:
This study, using 2005-2011 National Surgical Quality Improvement Program data, examined patients with pancreatitis or benign neoplasms. Morbidity after TP alone was compared with that after TP + IAT.
RESULTS:
In 126 patients (40%) undergoing TP and 191 (60%) patients undergoing TP + IAT, the most common diagnosis was chronic pancreatitis. Benign neoplasms were present in 46 (14%) patients, six of whom underwent TP + IAT. Patients in the TP + IAT group were younger and had fewer comorbidities than those in the TP group. Despite this, major morbidity was more frequent after TP + IAT than after TP [n = 79 (41%) versus n = 36 (29%); P = 0.020]. Transfusions were more common after TP + IAT [n = 39 (20%) versus n = 9 (7%); P = 0.001], as was longer hospitalization (13 days versus 9 days; P < 0.0001). There was no difference in mortality.
CONCLUSIONS:
This study is the only comparative, multicentre study of TP and TP + IAT. The TP + IAT group experienced higher rates of major morbidity and transfusion, and longer hospitalizations. Better data on the longterm benefits of TP + IAT are needed. In the interim, this study should inform physicians and patients regarding the perioperative risks of TP + IAT.
AuthorsNeil H Bhayani, Laura M Enomoto, Jennifer L Miller, Gail Ortenzi, Jussuf T Kaifi, Eric T Kimchi, Kevin F Staveley-O'Carroll, Niraj J Gusani
JournalHPB : the official journal of the International Hepato Pancreato Biliary Association (HPB (Oxford)) Vol. 16 Issue 6 Pg. 522-7 (Jun 2014) ISSN: 1477-2574 [Electronic] England
PMID23992021 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Observational Study)
Copyright© 2013 International Hepato-Pancreato-Biliary Association.
Topics
  • Adolescent
  • Adult
  • Aged
  • Blood Transfusion
  • Comorbidity
  • Female
  • Humans
  • Islets of Langerhans Transplantation (adverse effects, methods, mortality)
  • Length of Stay
  • Male
  • Middle Aged
  • Pancreatectomy (adverse effects, mortality)
  • Pancreatic Neoplasms (diagnosis, mortality, surgery)
  • Pancreatitis, Chronic (diagnosis, mortality, surgery)
  • Postoperative Complications (etiology, mortality, therapy)
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Transplantation, Autologous
  • Treatment Outcome
  • United States
  • Young Adult

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