Mini Review
Patient Demographics, Perioperative Testing, and Symptom Management in Total Pancreatectomy with Islet Autotransplantation: A Brief Review
Author(s): Claire L. DeBolt, Joshua S. Jolissaint, Jacob A. Tatum, Daniel S. Strand, Andrew Y. Wang, Victor Zaydfudim, Reid B. Adams and Kenneth L. BraymanClaire L. DeBolt, Joshua S. Jolissaint, Jacob A. Tatum, Daniel S. Strand, Andrew Y. Wang, Victor Zaydfudim, Reid B. Adams and Kenneth L. Brayman
Background Chronic pancreatitis and its resultant pain, glandular dysfunction, and detriment to quality of life is a challenging and resource-intensive problem for health care systems despite the plethora of modalities developed to treat it. Removal of the gland and source of pain via total pancreatectomy is an effective, albeit drastic solution, with the potential for morbidity due to the complete loss of endocrine and exocrine function. The consequent “brittle diabetes” due to loss of endocrine function and glucagon-dependent counter-regulation may be ameliorated by autologous islet transplantation. Unfortunately, factors leading to optimal outcomes are poorly defined. Results Data is mixed and limited to case series from institutions currently performing the procedure, but factors predictive of islet cell yields and overall insulin-independence include: disease etiol.. View More»
