The role of total pancreatectomy with islet autotransplantation in the treatment of chronic pancreatitis: A report from the International Consensus Guidelines in chronic pancreatitis

Maisam Abu-El-Haija¹, Takayuki Anazawa², Gregory J Beilman³, Marc G Besselink⁴, Marco Del Chiaro⁵, Ihsan Ekin Demir⁶, Ashley R Dennison⁷, Vikas Dudeja⁸, Martin L Freeman⁹, Helmut Friess⁶, Thilo Hackert¹⁰, Jorg Kleeff¹¹, Johanna Laukkarinen¹², Marlon F Levy¹³, Jaimie D Nathan¹⁴, Jens Werner¹⁵, John A Windsor¹⁶, John P Neoptolemos¹⁷, Andrea R G Sheel¹⁸, Tooru Shimosegawa¹⁹, David C Whitcomb²⁰, Melena D Bellin²¹

Affiliations

¹ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
² Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Japan.
³ Department of Surgery, University of Minnesota Medical Center, Minneapolis, MN, USA.
⁴ Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands.
⁵ Department of Surgery, University of Colorado Anschutz Medical Campus, Denver, CO, USA.
⁶ Department of Surgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
⁷ Department of Hepatobiliary and Pancreatic Surgery, University of Leicester, UK.
⁸ Department of Surgery, University of Miami, Miami, FL, USA.
⁹ Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
¹⁰ Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Germany.
¹¹ Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
¹² Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere University, Finland.
¹³ Division of Transplant Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.
¹⁴ Division of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
¹⁵ Department of General, Visceral, and Transplant Surgery, University of Munich, LMU, Germany.
¹⁶ Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
¹⁷ Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
¹⁸ Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
¹⁹ Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
²⁰ Department of Medicine, Cell Biology & Physiology, and Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA.
²¹ Department of Surgery, University of Minnesota Medical Center, Minneapolis, MN, USA; Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA. Electronic address: bell0130@umn.edu.

PMID: 32327370
DOI: 10.1016/j.pan.2020.04.005

The role of total pancreatectomy with islet autotransplantation in the treatment of chronic pancreatitis: A report from the International Consensus Guidelines in chronic pancreatitis

Maisam Abu-El-Haija et al. Pancreatology. 2020 Jun.

. 2020 Jun;20(4):762-771.

doi: 10.1016/j.pan.2020.04.005. Epub 2020 Apr 14.

Authors

Affiliations

¹ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
² Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Japan.
³ Department of Surgery, University of Minnesota Medical Center, Minneapolis, MN, USA.
⁴ Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands.
⁵ Department of Surgery, University of Colorado Anschutz Medical Campus, Denver, CO, USA.
⁶ Department of Surgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
⁷ Department of Hepatobiliary and Pancreatic Surgery, University of Leicester, UK.
⁸ Department of Surgery, University of Miami, Miami, FL, USA.
⁹ Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
¹⁰ Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Germany.
¹¹ Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
¹² Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere University, Finland.
¹³ Division of Transplant Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.
¹⁴ Division of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
¹⁵ Department of General, Visceral, and Transplant Surgery, University of Munich, LMU, Germany.
¹⁶ Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
¹⁷ Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
¹⁸ Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
¹⁹ Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
²⁰ Department of Medicine, Cell Biology & Physiology, and Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA.
²¹ Department of Surgery, University of Minnesota Medical Center, Minneapolis, MN, USA; Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA. Electronic address: bell0130@umn.edu.

PMID: 32327370
DOI: 10.1016/j.pan.2020.04.005

Abstract

Background: Advances in our understanding of total pancreatectomy with islet autotransplantation (TPIAT) have been made. We aimed to define indications and outcomes of TPIAT.

Methods: Expert physician-scientists from North America, Asia, and Europe reviewed the literature to address six questions selected by the writing group as high priority topics. A consensus was reached by voting on statements generated from the review.

Results: Consensus statements were voted upon with strong agreement reached that (Q1) TPIAT may improve quality of life, reduce pain and opioid use, and potentially reduce medical utilization; that (Q3) TPIAT offers glycemic benefit over TP alone; that (Q4) the main indication for TPIAT is disabling pain, in the absence of certain medical and psychological contraindications; and that (Q6) islet mass transplanted and other disease features may impact diabetes mellitus outcomes. Conditional agreement was reached that (Q2) the role of TPIAT for all forms of CP is not yet identified and that head-to-head comparative studies are lacking, and that (Q5) early surgery is likely to improve outcomes as compared to late surgery.

Conclusions: Agreement on TPIAT indications and outcomes has been reached through this working group. Further studies are needed to answer the long-term outcomes and maximize efforts to optimize patient selection.

Keywords: Autoislet; Diabetes; Pancreatectomy; Pancreatitis; TPIAT.

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The role of total pancreatectomy with islet autotransplantation in the treatment of chronic pancreatitis: A report from the International Consensus Guidelines in chronic pancreatitis

Affiliations

The role of total pancreatectomy with islet autotransplantation in the treatment of chronic pancreatitis: A report from the International Consensus Guidelines in chronic pancreatitis

Authors

Affiliations

Abstract

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous