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Updated: Mar 25, 2026
Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy
Published on: November 20, 2021
[Total Pancreatectomy and Islet Autotransplantation in a Child with Recurrent Pancreatitis]
R Grützmann1, B Ludwig2, J Weitz3
1Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Erlangen, Deutschland.
Insights
Total pancreatectomy with islet autotransplantation offers pain relief for children with hereditary pancreatitis. This spleen-preserving surgery can prevent or reduce diabetes after pancreas removal.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Gastroenterology
Background:
- Hereditary pancreatitis is a rare condition in children, often requiring surgical intervention for intractable pain and complications.
- Current surgical options include duodenum-preserving resections and drainage, but recurrences are common due to diffuse pancreatic involvement.
Observation:
- This video demonstrates a spleen-preserving total pancreatectomy with islet autotransplantation in a 10-year-old child with chronic recurrent pancreatitis.
- The procedure involves reconstruction with hepatico-jejunostomy and duodeno-jejunostomy, followed by islet autotransplantation into the portal vein.
Findings:
- Total pancreatectomy effectively manages pain in the majority of pediatric patients with symptomatic hereditary pancreatitis.
- Combining total pancreatectomy with islet autotransplantation can attenuate or prevent pancreoprivic diabetes mellitus.
Implications:
- Spleen-preserving total pancreatectomy is a safe and beneficial procedure for highly selected pediatric patients when performed by experienced surgeons.
- This approach offers a significant advantage over purely symptomatic management for severe hereditary pancreatitis.
Introduction:
Hereditary pancreatitis in children is rare. The indications for surgery in these children are complications and severe pain that cannot be managed by conservative treatment. Surgical treatment options are duodenum preserving resections as well as drainage procedures. Recurrences are common following theses surgical procedures, because usually the whole pancreas is affected. The majority of the children with symptomatic hereditary pancreatitis are free of pain after total pancreatectomy. When total pancreatectomy is combined with islet autotransplantation, pancreoprivic diabetes can be attenuated or even prevented. The principle of spleen-preserving total pancreatectomy combined with subsequent islet autotransplantation is shown in a case of a 10-year-old child with chronic recurrent pancreatitis in this video.
Indication:
Symptomatic chronic hereditary pancreatitis in children.
Procedure:
Spleen-preserving total pancreatectomy, reconstruction with hepatico-jejunostomy and duodeno-jejunostomy, islet autotransplantation via portal vein.
Conclusion:
If the surgeon has appropriate experience, spleen-preserving total pancreatectomy is a safe procedure. In combination with islet autotransplantation, it may attenuate or prevent diabetes mellitus associated with total pancreatectomy. In highly selected pediatric patients, this surgical procedure has a major benefit compared to a purely symptomatic therapy.
