Impact of total pancreatectomy with islet cell transplant on chronic pancreatitis management at a disease-based center

Abstract

Because of poor outcomes with traditional surgical management, total pancreatectomy with autologous islet transplantation (TPAIT) has been heralded as a breakthrough in the management of severe chronic pancreatitis intractable to medical management. To assess the impact of TPAIT on a pancreatobiliary disease-based center, a retrospective review and analysis of patients who underwent TPAIT after failing traditional surgical management was undertaken. Seven patients who underwent TPAIT were identified. Patient hospitalizations, emergency department visits, and clinic visits in the year pre- and post-TPAIT were tabulated. Average body weights and serum prealbumin were recorded during the year pre- and post-TPAIT. Based on the number of hospitalizations, clinic visits, and emergency department visits as an indicator of overall symptom severity, patients experienced an improvement in symptoms during the 12 months after TPAIT. Prealbumin values remained stable during the postoperative year. An observed decrease in weight suggests that other factors may be impacting the overall state of nutrition. The impact of TPAIT on the surgical management of chronic pancreatitis is limited in scope and benefit and continues to require careful analysis to identify appropriate candidates.