Metabolic and target organ outcomes after total pancreatectomy: Mayo Clinic experience and meta‐analysis of the literature

Abstract

The primary factor determining survival after TP is the aetiology necessitating TP, i.e. pancreatic malignancy. Most respondents used complex insulin programmes, but hypoglycaemia continues to be a problem.

The Clinical Outcomes after Total Pancreatectomy

“…Therefore, mortality due to diabetic complications or metabolic consequences of pancreatic resection during long-term follow-up after TP was eliminated [20,45] . The weight loss might be multifactorial and related to poor oral intake and maldigestion that causes malabsorption [48] . In the early phase after TP, consideration should be given to providing all the patients with supplemental enteral feeding for several weeks postoperatively [45] .…”

“…We reviewed the endocrine and exocrine replacement therapies and clinicophysiological parameters after TP ( table 3 ) [2,9,26,43,[45][46][47][48] . All patients required insulin and exocrine pancreatic enzyme replacement.…”

Single-centre experience of extending indications for percutaneous intraportal islet autotransplantation (PIPIAT) after pancreatic surgery to prevent diabetes: feasibility, radiological aspects, complications and clinical outcome

“…10 Another type of diabetes is known as "pancreatogenic diabetes", an extreme disruption of glucose homeostasis caused by the loss of parenchyma after pancreatic resection such as total/subtotal pancreatectomy for chronic pancreatitis or tumours. 11,12 The percentage of patients undergoing pancreatectomy that develop pancreatogenic diabetes is 8-23% increasing up to 40-50% during the follow-up; 13,14 pancreatogenic diabetes can be prevented by percutaneous intraportal islet autotransplantation (PIPIAT), which is performed 12-48 h after surgery, does not require immunosuppression and has a lower rejection rate than allotransplantation. 15 The technical procedure of autotransplantation, as in allotransplantation, consists in isolation, centrifugation and percutaneous intraportal infusion of pancreatic islets, performed using a combined ultrasonographic and fluoroscopic guidance, 16 to reduce periprocedural complications.…”

A Successful Case of Transcatheter Arterial Embolization with N-butyl-2-cyanoacrylate for Pancreatic Arteriovenous Malformation

“…p value less than 0.05 was considered statistically significant. TAE: transcatheter arterial embolization rate of 5% for total pancreatectomy and postoperative problems (16).…”