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World J Gastrointest Surg. 2016 Sep 27;8(9):634-642.

Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center.

Author information

1
Hazem M Zakaria, Department of Hepatopancreatobiliary and Liver Transplantation Surgery, National Liver Institute, Menoufia University, Al-Minufya 22732, Egypt.

Abstract

AIM:

To identify the current indications and outcomes of total pancreatectomy at a high-volume center.

METHODS:

A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed.

RESULTS:

One hundred and three patients underwent total pancreatectomy for indications including: Pancreatic ductal adenocarcinoma (n = 42, 40.8%), intraductal papillary mucinous neoplasms (n = 40, 38.8%), chronic pancreatitis (n = 8, 7.8%), pancreatic neuroendocrine tumors (n = 7, 6.8%), and miscellaneous (n = 6, 5.8%). The mean age was 66.2 years, and 59 (57.3%) were female. Twenty-four patients (23.3%) underwent a laparoscopic total pancreatectomy. Splenic preservation and portal vein resection and reconstruction were performed in 24 (23.3%) and 18 patients (17.5%), respectively. The 90 d major complications, readmission, and mortality rates were 32%, 17.5%, and 6.8% respectively. The 1-, 3-, 5-, and 7-year survival for patients with benign indications were 84%, 82%, 79.5%, and 75.9%, and for malignant indications were 64%, 40.4%, 34.7% and 30.9%, respectively.

CONCLUSION:

Total pancreatectomy, including laparoscopic total pancreatectomy, appears to be an appropriate option for selected patients when treated at a high-volume pancreatic center and through a multispecialty approach.

KEYWORDS:

Intraductal papillary mucinous neoplasms; Laparoscopic total pancreatectomy; Laparoscopy; Pancreas cancer; Pancreas cyst; Pancreatic ductal adenocarcinoma

Conflict of interest statement

Conflict-of-interest statement: Dr. Zakaria, Dr. Stauffer, Dr. Raimondo, Dr. Woodward, Dr. Wallace and Dr. Asbun report no biomedical financial interests or potential conflict of interest.

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