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Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications

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 aut...

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Autores principales: Jabłońska, Beata, Mrowiec, Sławomir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235694/
https://www.ncbi.nlm.nih.gov/pubmed/34202998
http://dx.doi.org/10.3390/jcm10122723
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author Jabłońska, Beata
Mrowiec, Sławomir
author_facet Jabłońska, Beata
Mrowiec, Sławomir
author_sort Jabłońska, Beata
collection PubMed
description 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.
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spelling pubmed-82356942021-06-27 Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications Jabłońska, Beata Mrowiec, Sławomir J Clin Med Review 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. MDPI 2021-06-20 /pmc/articles/PMC8235694/ /pubmed/34202998 http://dx.doi.org/10.3390/jcm10122723 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Jabłońska, Beata
Mrowiec, Sławomir
Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications
title Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications
title_full Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications
title_fullStr Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications
title_full_unstemmed Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications
title_short Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications
title_sort total pancreatectomy with autologous islet cell transplantation—the current indications
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235694/
https://www.ncbi.nlm.nih.gov/pubmed/34202998
http://dx.doi.org/10.3390/jcm10122723
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