Is Total Pancreatectomy with Islet Autotransplantation Indicated in Hereditary/Genetic Pancreatitis?
Total pancreatectomy with islet autotransplantation (TPIAT) has been used in selected centers to treat intractable hereditary/genetic forms of recurrent acute and chronic pancreatitis. It has theoretical advantages over continued medical management or traditional endoscopic and surgical interventions because it entails the complete removal of the inflamed and fibrotic organ to treat the symptoms of pain while both eliminating the long-term risk of pancreatic ductal adenocarcinoma and preserving islet mass and to limit post-pancreatectomy diabetes. While an emerging consensus favors TPIAT in this setting, the evidence base largely relies on retrospective patient series and expert opinion.
KeywordsChronic pancreatitis Recurrent acute pancreatitis Hereditary pancreatitis Islet autotransplantation PRSS1 Total pancreatomy
- 15.Wilson GC, Sutton JM, Smith MT. Total pancreatectomy and islet cell autotransplantation as the initial treatment for minimal-change chronic pancreatitis. HPB. 2014;17:232–8.Google Scholar
- 21.Georgiev G, Beltran del Rio M, Gruessner A, et al. Patient quality of life after autologous islet transplantation (AIT) for treatment of chronic pancreatitis: 53 patient series at the University of Arizona. Pancreatology. 2014;15:40–5.Google Scholar
- 22.Tai DS, Shen N, Szot GL, et al. Autologous islet transplantation with remote islet isolation after pancreas resection for chronic pancreatitis. JAMA Surg. 2014;150:118–24.Google Scholar