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Published on: December 14, 2019
Total pancreatectomy for chronic pancreatitis
I P Linehan1, M A Lambert, D C Brown
1Department of Surgery, Middlesex Hospital, London.
Gut
|March 1, 1988
Summary
Total pancreatectomy, a rare surgery for chronic pancreatitis, shows improved pain in over 80% of patients. Duodenum-preserving total pancreatectomy (DPTP) offers better diabetic control and fewer complications than standard total pancreatectomy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endocrinology
Background:
- Total pancreatectomy is a rare procedure for chronic pancreatitis.
- Its role in managing chronic pancreatitis requires further elucidation.
Purpose of the Study:
- To evaluate the outcomes of total pancreatectomy for benign pancreatic disease.
- To compare standard total pancreatectomy with duodenum-preserving total pancreatectomy (DPTP).
Main Methods:
- Retrospective review of 29 total pancreatectomies (12 standard, 17 DPTP) for benign disease.
- Comparison of outcomes with age and sex-matched diabetic control subjects.
- Analysis of complications, postoperative stay, and metabolic control (hypoglycemia, body weight, insulin requirement, HbA1c).
Main Results:
- One death (3.4% mortality); no re-operations required.
- DPTP group had fewer major hypoglycemic episodes (2 vs. 5) and better metabolic control compared to standard total pancreatectomy.
- Both procedures required significant enzyme replacement therapy, crucial for diabetic control.
Conclusions:
- Total pancreatectomy can improve pain in over 80% of patients with chronic pancreatitis.
- DPTP demonstrates superior outcomes in terms of diabetic control and complication rates.
- Long-term results are promising with careful management of pain, enzyme deficiency, and diabetes.
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