Morbidity of total pancreatectomy with islet cell auto‐transplantation compared to total pancreatectomy alone. Issue 6 (29th August 2013)

• Record Type: Journal Article
• Authors: Bhayani, Neil H.; Enomoto, Laura M.; Miller, Jennifer L.; Ortenzi, Gail; Kaifi, Jussuf T.; Kimchi, Eric T.; Staveley‐O'Carroll, Kevin F.; Gusani, Niraj J.
• Is Part Of: HPB. Volume 16:Issue 6(2014:Jun.)
• Page Start: 522
• Page End: 527
• Publication Date: 2013-08-29
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/hpb.12168
• Languages: English
• ISSNs: 1365-182X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hpb12168-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="hpb12168-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="hpb12168-sec-0003" sec-type="section"> <title>Results</title> <p>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 [<italic>n</italic> = 79 (41%) versus <italic>n</italic> = 36 (29%); <italic>P</italic> = 0.020]. Transfusions were more common after TP + IAT [<italic>n</italic> = 39 (20%) versus <italic>n</italic> = 9 (7%); <italic>P</italic> = 0.001], as was longer hospitalization (13 days versus 9 days; <italic>P</italic> < 0.0001). There was no difference in mortality.</p> </sec> <sec id="hpb12168-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>