Abstract
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.
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Ahmad SA, Wray C, Rilo HL, et al. Chronic pancreatitis: recent advances and ongoing challenges. Curr Prob Surg. 2006;43:127–238.
Rebours V, Levy P, Ruszniewski P. An overview of hereditary pancreatitis. Dig Liver Dis. 2012;44:8–15.
Rebours V, Boutron-Ruault MC, Schnee MF, et al. Risk of pancreatic adenocarcinoma in patients with hereditary pancreatitis: a national exhaustive series. Am J Gastroenterol. 2008;103:111–9.
Keim V, Bauer N, Teich N, et al. Clinical characterization of patients with hereditary pancreatitis and mutations in the cationic trypsinogen gene. Am J Med. 2001;111:622–6.
Matsubayashi H, Fukushima N, Sato N, et al. Polymorphisms of SPINK1 N34S and CFTR in patients with sporadic and familial pancreatic cancer. Cancer Biol Ther. 2003;2:652–5.
Bellin MD, Freeman ML, Gelrud A, et al. Total pancreatectomy and islet autotransplantation in chronic pancreatitis: recommendations from PancreasFest. Pancreatology. 2014;14:27–35.
Bellin MD, Gelrud A, Arreaza-Rubin G, et al. Total pancreatectomy with islet autotransplantation: summary of a National Institute of Diabetes and Digestive and Kidney Diseases workshop. Pancreas. 2014;43:1163–71.
Chinnakotla S, Bellin MD, Schwarzenberg SJ, et al. Total pancreatectomy and islet autotransplantation in children for chronic pancreatitis. Ann Surg. 2014;260:56–64.
Chinnakotla S, Radosevich DM, Dunn TB, et al. Long-term outcomes of total pancreatectomy and islet auto transplantation for hereditary/genetic pancreatitis. J Am Coll Surg. 2014;218:530–45.
Sutherland DER, Radosevich DM, Bellin MD. Total pancreatectomy and islet autotransplantation for chronic pancreatitis. J Am Coll Surg. 2012;214:409–26.
Bellin MD, Freeman ML, Schwarzenberg SJ, et al. Quality of life improves for pediatric patients after total pancreatectomy and islet autotransplant for chronic pancreatitis. Clin Gastroenterol Hepatol. 2011;9:793–9.
Sutton JM, Schmulewitz N, Sussman JJ, et al. Total pancreatectomy and islet cell autotransplantation as a means of treating patients with genetically linked pancreatitis. Surgery. 2010;148:676–86.
Wilson GC, Sutton JM, Salehi M, et al. Surgical outcomes after total pancreatectomy and islet cell autotransplantation in pediatric patients. Surgery. 2013;154:777–84.
Wilson GC, Sutton JM, Abbott DE, et al. Long-term outcomes after total pancreatectomy and islet cell autotransplantation: is it a durable operation? Ann Surg. 2014;260:659–67.
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.
Garcea G, Pollard CA, Illouz S, et al. Patient satisfaction and cost-effectiveness following total pancreatectomy with islet cell transplantation for chronic pancreatitis. Pancreas. 2013;42:322–8.
Bhayani NH, Enomoto LM, Miller JL, et al. Morbidity of total pancreatectomy with islet cell auto-transplantation compared to total pancreatectomy alone. HPB. 2014;16:522–7.
Laje P, Adzick NS. Modified Puestow procedure for the management of chronic pancreatitis in children. J Ped Surg. 2013;48:2271–5.
Schmitt F, Le Henaff G, Piloquet H, et al. Hereditary pancreatitis in children: surgical implications with special regard to genetic background. J Ped Surg. 2009;44:2078–82.
Wilson GC, Ahmad SA, Schauer DP, et al. Cost-effectiveness of total pancreatectomy and islet cell autotransplantation for the treatment of minimal change pancreatitis. J Gastrointest Surg. 2015;19:46–55.
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.
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.
Morgan K, Owczarski SM, Borckardt J, et al. Pain control and quality of life after pancreatectomy with islet autotransplantation for chronic pancreatitis. J Gastrointest Surg. 2012;16:129–34.
Walsh RM, Aguilar-Saavedra JR, Lentz G, et al. Improved quality of life following total pancreatectomy and autoislet transplantation for chronic pancreatitis. J Gastrointest Surg. 2012;16:1469–77.
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Matthews, J.B. (2016). Is Total Pancreatectomy with Islet Autotransplantation Indicated in Hereditary/Genetic Pancreatitis?. In: Millis, J., Matthews, J. (eds) Difficult Decisions in Hepatobiliary and Pancreatic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-27365-5_44
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DOI: https://doi.org/10.1007/978-3-319-27365-5_44
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