Pancreatic Islet Autotransplantation With Completion Pancreatectomy in the Management of Uncontrolled Pancreatic Fistula After Whipple Resection for Ampullary Adenocarcinoma

Alsaif, Faisal; Molinari, Michele; Al-Masloom, Abdulmuttalib; Lakey, Jonathan R.T.; Kin, Tatsuya; Shapiro, A. M. James

doi:10.1097/01.mpa.0000220871.18153.a9

Cited by 30 publications

(15 citation statements)

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“…To date, there are no published reports of pancreatic malignant disease or metastases occurring in the liver and related to IAT. Four patients with malignant diseases undergoing IAT were previously described as "case report" 28,[30][31][32] ; all remained without evidence of liver recurrence at follow-up up to 3 to 30 months. In our cohort 17 subjects with cancer received IAT and we report no liver recurrences.…”

Section: Discussionmentioning

confidence: 99%

Extending Indications for Islet Autotransplantation in Pancreatic Surgery

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Extending Indications for Islet Autotransplantation in Pancreatic Surgery

et al. 2013

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“…The fear of infusion of occult carcinoma cells in the islet preparation has limited the use of this procedure for patients with pancreatic adenocarcinoma, although there have been a few published case reports [48, 49]. In one study, islet cell autotransplant was performed in two patients with IPMN, one who underwent TP, and another underwent partial pancreatectomy, in which IPMN was confined to the pancreatic body on imaging, with no evidence of recurrence at one-year followup [50].…”

Section: Discussionmentioning

confidence: 99%

Glycemic Control after Total Pancreatectomy for Intraductal Papillary Mucinous Neoplasm: An Exploratory Study

et al. 2012

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Background. Glycemic control following total pancreatectomy (TP) has been thought to be difficult to manage. Diffuse intraductal papillary mucinous neoplasm (IPMN) is a potentially curable precursor to pancreatic adenocarcinoma, best treated by TP. Objective. Compare glycemic control in patients undergoing TP for IPMN to patients with type 1 diabetes mellitus (DM). Design/Setting. Retrospective cohort. Outcome Measure. Hemoglobin A1C(HbA1C) at 6, 12, 18, and 24 months after TP. In the control group, baseline was defined as 6 months prior to the first HbA1c measure. Results. Mean HgbA1C at each point of interest was similar between TP and type I DM patients (6 months (7.5% versus 7.7%, P = 0.52), 12 months (7.3% versus 8.0%, P = 0.081), 18 months (7.7% and 7.6%, P = 0.64), and at 24 months (7.3% versus 7.8%, P = 0.10)). Seven TP patients (50%) experienced a hypoglycemic event compared to 65 type 1 DM patients (65%, P = 0.38). Limitations. Small number of TP patients, retrospective design, lack of long-termfollowup. Conclusion. This suggests that glycemic control following TP for IPMNcan be well managed, similar to type 1 DM patients. Fear of DM following TP for IPMN should not preclude surgery when TP is indicated.

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“…Total remnant pancreatectomy in this setting is associated with severe complications and high mortality as well as a complete loss of endocrine and exocrine function [3]. Recently, successful islet auto-transplantation was described to maintain glucose hemostasis after complete pancreatectomy, even for malignant indication [15]. In our opinion, this is not justified with regard to costs or logistics and is not an alternative to the presented pancreas-preserving technique.…”

Section: Discussionmentioning

confidence: 91%