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Laparoscopic Radical Left Pancreatectomy for Pancreatic Cancer: Surgical Strategy and Technique Video
Published on: June 6, 2020
Total pancreatectomy: indications, operative technique, and postoperative sequelae
David G Heidt1, Charles Burant, Diane M Simeone
1Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
Summary
Total pancreatectomy is a viable pancreatic surgery option for specific complex conditions. Postoperative management advances, including auto-islet transplantation, improve patient outcomes and quality of life.
Area of Science:
- Gastroenterology and Surgical Oncology
- Endocrinology and Metabolic Diseases
Background:
- Total pancreatectomy is a treatment for pancreatic diseases but poses challenges due to resulting endocrine and exocrine insufficiency.
- Management of the a-pancreatic state has historically limited the application of this procedure.
Purpose of the Study:
- To review the indications for total pancreatectomy.
- To discuss operative techniques and recent advancements in postoperative patient management.
Main Methods:
- Review of current literature and clinical practices regarding total pancreatectomy.
- Analysis of improvements in managing the a-pancreatic state post-surgery.
Main Results:
- Total pancreatectomy is indicated for intractable chronic pancreatitis pain, extensive neuroendocrine tumors, familial pancreatic cancer, and advanced intraductal papillary mucinous neoplasia.
- Postoperative management improvements include auto-islet cell transplantation, advanced insulin therapies, and glucagon rescue therapy.
Conclusions:
- Total pancreatectomy is a feasible treatment option for select pancreatic conditions.
- Enhanced postoperative care significantly mitigates risks associated with a-pancreatic state, improving patient quality of life.
