Total pancreatectomy for the treatment of pancreatic neoplasms

Abstract

TP should be considered in selective cases for treatment of pancreatic neoplasm if it allows complete clearance. The procedure does not appear to be associated with significant increases in serious complications compared with PD.

The Clinical Outcomes after Total Pancreatectomy

“…The rates of other clinically significant complications were similar between the 2 groups [41] . While 3 reports showed no differences in morbidity between TP and PD [4,9,42] , 3 showed significant differences between these procedures [16,40,41] . While the perioperative mortality rates for TP have decreased in recent years, perioperative morbidity after TP did not decrease significantly (1970-1989: 70.0%; 1990-1999: 70.3%; 2000-2007: 66.0%; p = 1.0) [40] .…”

“…In these papers, the morbidity rates were 31-87% and included delayed gastric emptying, bleeding, infections, and problems with glycemic control. Nikfarjam et al [41] reported a higher morbidity rate with a significantly greater number of grade-1 complications according to the Clavien-Dindo classification system, reflecting a high postoperative hypoglycemia rate. The rates of other clinically significant complications were similar between the 2 groups [41] .…”

“…Nikfarjam et al [41] reported a higher morbidity rate with a significantly greater number of grade-1 complications according to the Clavien-Dindo classification system, reflecting a high postoperative hypoglycemia rate. The rates of other clinically significant complications were similar between the 2 groups [41] . While 3 reports showed no differences in morbidity between TP and PD [4,9,42] , 3 showed significant differences between these procedures [16,40,41] .…”

“…The operative mortality after TP has been decreasing gradually with no changes in the morbidity rates [23,40] . Portal vein or superior mesenteric vein resection was performed in 11.8-50% of the patients who underwent TP [9,[40][41][42][43][44] , and they were performed more commonly than PD [41] . However, the arterial resection of hepatic or superior mesenteric artery or the celiac trunk was independently associated with in-hospital mortality in univariate and multivariate analyses.…”

"Diabetes Associated Genes from the Dark Matter of the Human Proteome"

“…13,14 The complications associated with diabetes involve numerous other disorders such as cardiovascular, developmental, immune, metabolic, neurodegenerative, obesity, renal and vision. [15][16][17][18][19] Both of the two major forms of diabetes, type 1, an autoimmune disease 20,21 and type 2, a metabolic disorder, [22][23][24][25] require novel approaches to early diagnosis and therapy. [26][27][28][29] Notwithstanding the availability of several classes of anti-diabetic drugs, it is often difficult to maintain long-term glycemic control and many current agents have treatment-limiting side effects.…”