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Total pancreatectomy and islet autotransplantion for chronic and recurrent acute pancreatitis

McEachron, Kendall R.a; Bellin, Melena D.a,b

Current Opinion in Gastroenterology: September 2018 - Volume 34 - Issue 5 - p 367–373
doi: 10.1097/MOG.0000000000000458
PANCREAS: Edited by Timothy B. Gardner

Purpose of review We reviewed the current state of total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis and recurrent acute pancreatitis (RAP).

Recent findings An increasing number of centers in the United States and internationally are performing TPIAT. In selected cases, TPIAT may be performed partially or entirely laparoscopically. Islet isolation is usually performed at the same center as the total pancreatectomy surgery, but new data suggest that diabetes outcomes may be nearly as good when a remote center is used for islet isolation. Ongoing clinical research is focused on patient and disease factors that predict success or failure to respond to TPIAT. Causes of persistent abdominal pain after TPIAT may include gastrointestinal dysmotility and central sensitization to pain. Several clinical trials are underway with anti-inflammatory or other islet protective strategies to better protect islets at the time of infusion and thereby improve the diabetes results of the procedure.

Summary In summary, there is an increasing body of literature emerging from multiple centers highlighting the benefits and persistent challenges of TPIAT for chronic pancreatitis and RAP. Ongoing study will be critical to optimizing the success of this procedure.

aDepartment of Surgery

bDepartment of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA

Correspondence to Melena D. Bellin, MD, University of Minnesota Masonic Children's Hospital, East Building Room MB 671, 2450 Riverside Ave S, Minneapolis, MN 55454, USA. Tel: +1 612 626 5716; fax: +1 612 626 5262; e-mail: bell0130@umn.edu

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