ReviewTotal Pancreatectomy for Pancreatic Carcinoma When, Why, and What Are the Outcomes? Results of a Systematic ReviewPetrucciani, Niccolo MD, PhD*; Nigri, Giuseppe MD, PhD, FACS*; Giannini, Giulia MD*; Sborlini, Elena MD*; Antolino, Laura MD*; de'Angelis, Nicola MD, PhD†; Gavriilidis, Paschalis MD, PhD‡; Valente, Roberto MD, PhD§; Lainas, Panagiotis MD, PhD∥,¶; Dagher, Ibrahim MD, PhD∥,¶; Debs, Tarek MD**; Ramacciato, Giovanni MD, FACS*Author Information From the *Department of Medical and Surgical Sciences and Translational Medicine, St Andrea University Hospital, Sapienza University, Rome, Italy †Department of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor University Hospital, AP-HP, UPEC University, Créteil, France ‡Department of Surgery, Northampton General Hospital NHS Trust, Northampton, United Kingdom §Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden ∥Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, AP-HP, Clamart ¶Paris-Sud University, Orsay **Division of Digestive Surgery and Liver Transplantation, Nice University Hospital, Nice, France. Received for publication June 13, 2019; accepted December 17, 2019. Address correspondence to: Niccolo Petrucciani, MD, PhD, Department of Medical and Surgical Sciences and Translational Medicine, St Andrea Hospital, Sapienza University, via di Grottarossa 1035-1039, 00189 Rome, Italy (e-mail: email@example.com). The authors declare no conflict of interest. Online date: February 3, 2020 Pancreas: February 2020 - Volume 49 - Issue 2 - p 175-180 doi: 10.1097/MPA.0000000000001474 Buy Metrics Abstract The role of total pancreatectomy (TP) to treat pancreatic carcinoma is still debated. The aims of this study were to systematically review the previous literature and to summarize the indications and results of TP for pancreatic carcinoma. A systematic search was performed to identify all studies published up to November 2018 analyzing the survival of patients undergoing TP for pancreatic carcinoma. Clinical effectiveness was synthetized through a narrative review with full tabulation of results. Six studies published between 2009 and 2016 were retrieved, including 316 patients. The major indication was positive pancreatic margin at frozen section during partial pancreatectomy. The overall morbidity ranged from 36% to 69%, and mortality from 0% to 27%. Overall survival ranged from 52.7% to 67% at 1 year, from 20% to 42% at 3 years of follow-up, whereas the 5-year estimated overall survival ranged from 4.5% to 21.9%. Total pancreatectomy has an important role in the armamentarium of pancreatic surgeons. Postoperative morbidity and mortality are not negligible, but a trend for better postoperative outcomes in recent years is noticed. Mortality related to difficult glycemic control is rare. Long-term survival is comparable with survival after partial pancreatectomy for carcinoma. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.