scholarly journals Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications

2021 ◽  
Vol 10 (12) ◽  
pp. 2723
Author(s):  
Beata Jabłońska ◽  
Sławomir Mrowiec
Keyword(s):  
Total Pancreatectomy ◽  
Long Term Results ◽  
Pancreatic Tumors ◽  
Neuroendocrine Neoplasms ◽  
Islet Cell Transplantation ◽  
Pancreatic Stump ◽  
Primary Indication ◽  
Autologous Islet Transplantation ◽  
Endocrine Insufficiency

Total pancreatectomy is a major complex surgical procedure involving removal of the whole pancreatic parenchyma and duodenum. It leads to lifelong pancreatic exocrine and endocrine insufficiency. The control of surgery-induced diabetes (type 3) requires insulin therapy. Total pancreatectomy with autologous islet transplantation (TPAIT) is performed in order to prevent postoperative diabetes and its serious complications. It is very important whether it is safe and beneficial for patients in terms of postoperative morbidity and mortality, and long-term results including quality of life. Small duct painful chronic pancreatitis (CP) is a primary indication for TPAIT, but currently the indications for this procedure have been extended. They also include hereditary/genetic pancreatitis (HGP), as well as less frequent indications such as benign/borderline pancreatic tumors (intraductal papillary neoplasms, neuroendocrine neoplasms) and “high-risk pancreatic stump”. The use of TPAIT in malignant pancreatic and peripancreatic neoplasms has been reported in the worldwide literature but currently is not a standard but rather a controversial management in these patients. In this review, history, technique, indications, and contraindications, as well as short-term and long-term results of TPAIT, including pediatric patients, are described.

scholarly journals Short-and long-term results of distal pancreatectomy

2019 ◽  
Vol 36 (2) ◽  
pp. 6-13
Author(s):  
V. N. Barykov ◽  
A. G. Istomin ◽  
R. R. Abdrashitov ◽  
A. S. Ryzhikh
Keyword(s):  
Distal Pancreatectomy ◽  
Long Term Results ◽  
Benign Tumors ◽  
Pancreatic Stump ◽  
Pancreatogenic Diabetes ◽  
Pancreatic Fistulas ◽  
Short And Long Term ◽  
Wirsung Duct ◽  
One Year

Aim. To assess the results of distal pancreatectomy for malignant and benign tumors and chronic pancreatitis complications. Materials and methods. Forty-seven patients, who underwent distal pancreatectomy, were under observation during the period from 01.01.2008 to 28.02.2019. Results. The long-term results of surgical treatment demonstrated the following complications: pancreatic fistulas – 15 % of observations, pancreatogenic diabetes mellitus – 12.7 %, subphrenic abscesses – 10 %. In the long-term period after the surgery – from 10 years and not less than one year – 30 patients were followed up, constituting 63.8 % of the total number. Conclusions. To prevent complications in the form of pancreatic fistula with pathological Wirsung duct dilatation more than 4–5 mm in diameter, it is necessary to form anastomosis between the pancreatic stump and the small bowel.

scholarly journals Prevention of complications of pancreatoduodenal resection in pancreatic cancer

2020 ◽  
Vol 47 (2) ◽  
pp. 32-36
Author(s):  
A. P. Koshel ◽  
S. S. Klokov ◽  
Yu. Yu. Rakina ◽  
E. S. Drozdov ◽  
E. B. Mironova
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Surgical Treatment ◽  
Pancreatic Tumors ◽  
Distal Pancreatic Resection ◽  
Pancreatic Stump ◽  
Short And Long Term ◽  
Reconstructive Plastic

Introduction. Over the past few decades, the incidence of pancreatic cancer has dramatically increased worldwide. Despite the high prevalence of this oncological pathology, there is currently no consensus on the expediency of performing radical reconstructive-plastic surgeries in case of malignant pancreatic tumors. Aim: to study the influence of reconstructive-plastic techniques of surgical treatment of pancreatic cancer on the life expectancy of patients and its quality. Materials and methods. Analysis of the short and long-term outcomes of surgical treatment of pancreatic cancer was conducted. In total, radical operative interventions were carried out in 32 patients, including 14 men (56.25%) and 18 women (43,75%), aged 37 to 72 (61,5±10,0) years. Pyloro-preserving pancreatoduodenal resection was performed in 20 (62.5%) patients, gastropancreatoduodenal resection — in 6 (18.8%) patients, proximal resection — in 5 (15.6%) patients, distal pancreatic resection — in 1 case (3,1%). Areflux pancreatojejunal anastomosis was formed in patients by the clinic technique. Results. Hospital mortality was 6.25%. More than three years after surgery, 15.6% of patients are alive; the median survival rate is 19.5±2.4 months. An assessment of the quality of life and the function of the formed pancreatojejunostomy conducted in the immediate and remote periods showed that the presence of areflux valve reliably prevents the development of pancreatic stump, providing a high level of quality of life for patients. Conclusions. The use of organ-preserving and organ-modulating techniques in the treatment of operable pancreatic cancer does not affect survival, but provides an acceptable level of quality of life for patients in the short and long-term perspective after surgery.

scholarly journals Laparoscopic pancreatectomy for benign or low-grade malignant pancreatic tumors: outcomes in a single high-volume institution

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
He Cai ◽  
Lu Feng ◽  
Bing Peng
Keyword(s):  
Surgical Techniques ◽  
Operation Time ◽  
High Volume ◽  
Long Term Results ◽  
Pancreatic Tumors ◽  
Low Grade ◽  
Central Pancreatectomy ◽  
Laparoscopic Pancreatectomy ◽  
Spleen Preserving

Abstract Objective To investigate the perioperative and long-term outcomes of laparoscopic pancreatectomy for benign and low-grade malignant pancreatic tumors, and further compare the outcomes between different surgical techniques. Methods We retrospectively collected clinical data of consecutive patients with benign or low-grade malignant pancreatic tumors underwent surgery from February 2014 to February 2019. Patients were grouped and compared according to different surgical operations they accepted. Results Totally 164 patients were reviewed and 83 patients underwent laparoscopic pylorus-preserving pancreaticoduodenectomy (LPPPD), 41 patients underwent laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and 20 patients underwent laparoscopic central pancreatectomy (LCP) were included in this study, the rest 20 patients underwent laparoscopic enucleation were excluded. There were 53 male patients and 91 female patients. The median age of these patients was 53.0 years (IQR 39.3–63.0 years). The median BMI was 21.5 kg/m2 (IQR 19.7–24.0 kg/m2). The postoperative severe complication was 4.2% and the 90-days mortality was 0. Compare with LCP group, the LPPPD and LSPDP group had longer operation time (300.4 ± 89.7 vs. 197.5 ± 30.5 min, P < 0.001) while LSPDP group had shorter operation time (174.8 ± 46.4 vs. 197.5 ± 30.5 min, P = 0.027), more blood loss [140.0 (50.0–1000.0) vs. 50.0 (20.0–200.0) ml P < 0.001 and 100.0 (20.0–300.0) vs. 50.0 (20.0–200.0 ml, P = 0.039, respectively), lower rate of clinically relevant postoperative pancreatic fistula [3 (3.6%) vs. 8 (40.0%), P < 0.001 and 3 (7.3%) vs. 8 (40.0%), P = 0.006, respectively], lower rate of postpancreatectomy hemorrhage [0 (0%) vs. 2 (10.0%), P = 0.036 and (0%) vs. 2 (10.0%) P = 0.104, respectively] and lower rate of postoperative severe complications [2 (2.4%) vs.4 (20.0%), P = 0.012 and 0 (0%) vs. 4 (20.0%), P = 0.009, respectively], higher proportion of postoperative pancreatin and insulin treatment (pancreatin: 39.8% vs., 15% P = 0.037 and 24.4%vs. 15%, P = 0.390; insulin: 0 vs. 18.1%, P = 0.040 and 0 vs. 12.2%, P = 0.041). Conclusions Overall, laparoscopic pancreatectomy could be safely performed for benign and low-grade malignant pancreatic tumors while the decision to perform laparoscopic central pancreatectomy should be made carefully for fit patients who can sustain a significant postoperative morbidity and could benefit from the excellent long-term results even in a high-volume center.

Features of clinical course, morphological diagnosis and prognosis factors for neuroendocrine neoplasms of rare localizations

2020 ◽  
pp. 54-60
Author(s):  
D. V. Abbasova ◽  
S. B. Polikarpova ◽  
N. A. Kozlov ◽  
Ye. V. Artamonova ◽  
V. Yu. Kirsanov ◽  
...  
Keyword(s):  
Prostate Gland ◽  
Survival Rates ◽  
Long Term Results ◽  
Neuroendocrine Neoplasms ◽  
High Survival ◽  
Diagnosis And Prognosis ◽  
National Medical ◽  
Static Data ◽  
Morphological Diagnosis

Currently, neuroendocrine neoplasms (NENs) of the gastroenteropancreat-ic and bronchopulmonary systems are well studied and the most common, the share of which is 73 and 25 % of cases, respectively. The remaining 2 % of cases are attributed to NEN of more rare localizations, the static registration of which is difficult due to their rarity, and clinical cases are presented by episodic descriptions of single observations. Such tumors include NEN of the prostate gland from 0.5 to 1.0 %, NEN of ovaries 0.5 %, NEN of the mammary gland from 0.3 to 0.5 %, NEN of the kidney (practically devoid of static data), bladder 0.48-1.00 %. The retrospective study included 92 patients with NEN of rare localizations who were examined and treated of the N. N. Blochin National Medical Research Center of Oncology from 1990 to 2019. Currently, there are no generally accepted methods of treatment for this group of patients due to the rarity of the pathology, and it is carried out according to the NEN of other localizations. NEN of rare localizations have high survival rates (the observation period was from a month to 14 years), both general and without progression and require long-term monitoring and observation. At the time of assessment of long-term results, 20 (21.8 %) patients died of progression, 12 (13.1 %) patients dropped out of observation. The rest were alive at the date of the last control.

Long-term results of surgery for pancreatic neuroendocrine neoplasms in patients with MEN1

2011 ◽  
Vol 396 (8) ◽  
pp. 1187-1196 ◽  
Author(s):  
Caroline L. Lopez ◽  
Jens Waldmann ◽  
Volker Fendrich ◽  
Peter Langer ◽  
Peter H. Kann ◽  
...  
Keyword(s):  
Long Term Results ◽  
Neuroendocrine Neoplasms ◽  
Pancreatic Neuroendocrine Neoplasms ◽  
Results Of Surgery

Total Pancreatectomy for the Treatment of Chronic Pancreatitis: Indications, Outcomes, and Recommendations

2006 ◽  
Vol 72 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Stephen W. Behrman ◽  
Matthew Mulloy
Keyword(s):  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Total Pancreatectomy ◽  
Long Term Results ◽  
Gastrojejunal Anastomosis ◽  
Hereditary Pancreatitis ◽  
Anastomotic Complications ◽  
The Mean

Total pancreatectomy (TP) for chronic pancreatitis (CP) has not gained widespread acceptance because of concerns regarding technical complexity, diabetic complications, and uncertainty with respect to long-term pain relief. Records of patients having TP from 1997 to 2005 were reviewed. Patient presentation, etiology of disease, and the indication for TP were examined. Operative results were analyzed. Long-term results were critically assessed, including narcotic usage and the need for re-admission. Postoperative quality of life (QOL) was assessed by the SF-36 health survey. During the study period, 7 patients with CP had TP, and 28 had other operations. The etiology of CP was alcohol in four and hereditary pancreatitis in three. The indication for surgery was pain and weight loss. Preoperatively, all patients used narcotics chronically and two had insulin-dependent diabetes. Four had TP after failed previous surgical procedures. Endoscopic retrograde cholangiopancreatography and computed tomography demonstrated small ducts and atrophic calcified glands. The mean length of the operation was 468 minutes, and only two patients required transfusion. There were no biliary anastomotic complications. The mean length of stay was 14 days. Major morbidity was limited to a single patient with a leak from the gastrojejunal anastomosis. Thirty-day mortality was zero, with one late death unrelated to the surgical procedure or diabetes. The mean length of follow-up was 46 months. All patients remained alcohol and narcotic free. No patient was readmitted with a diabetic complication. When compared with the general population, QOL scores were diminished but reasonable. We conclude that TP is indicated in hereditary pancreatitis and in those with an atrophic, calcified pancreas with small duct disease; that TP is technically arduous but can be completed with very low morbidity and mortality; and that on long-term follow-up, pain relief and abstinence from alcohol and narcotics was excellent with an acceptable QOL.

scholarly journals Long-term Results after Total Pancreatectomy for Pancreatic Adenocarcinoma

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S921
Author(s):  
A. Severtsev ◽  
V. Stupin ◽  
D. Tchudaev ◽  
S. Gusarenko
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Total Pancreatectomy ◽  
Long Term Results
Sign in / Sign up

Export Citation Format

Share Document