Document Detail


Pancreatic resection with islet cell autotransplant for the treatment of severe chronic pancreatitis.
MedLine Citation:
PMID:  18556996     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pancreatic resection can alleviate pain in properly selected patients with severe chronic pancreatitis (CP), although the apancreatic state causes "brittle" diabetes. Islet auto-transplantation (IAT) after resection can decrease diabetes-related morbidity. Twenty-six consecutive patients with CP who underwent 27 pancreatic resections with IAT from April 2005 to December 2007 were evaluated in this retrospective case control study. Data were collected by chart and operative note reviews and query of hospital databases. Subgroup analysis was performed on 21 cases of total pancreatectomy and six cases of pancreaticoduodenectomy (PD). Mean age was 43.8 years and 46.2 per cent of patients were female. The most common etiology of CP was alcoholism (34.6%), followed by idiopathic causes (30.8%) and pancreatic divisum (23.1%). There was no mortality and the complication rate was 56 per cent. Islet equivalents infused and islet equivalents/gram of pancreas were 82,094 and 2,739 respectively. Mean discharge insulin dose was 10.7 units/day. Mean follow-up was 6.5 months. At 6 months, 80 per cent of patients reporting had decreased or eliminated their use of narcotic medication and all total pancreatectomy patients required insulin (mean 23 units/day). In appropriately selected patients, pancreatic resection with IAT is safe and effective for the treatment of intractable pain associated with CP.
Authors:
Joshua L Argo; Juan L Contreras; Mary M Wesley; John D Christein
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American surgeon     Volume:  74     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-17     Completed Date:  2008-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  530-6; discussion 536-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Islets of Langerhans Transplantation / methods*
Male
Middle Aged
Pancreatectomy / methods*
Pancreatitis, Chronic / surgery*
Retrospective Studies
Survival Rate
Transplantation, Autologous
Treatment Outcome
Grant Support
ID/Acronym/Agency:
5 T32 HS013852/HS/AHRQ HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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