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Pancreas. 2019 Oct;48(9):1204-1211. doi: 10.1097/MPA.0000000000001405.

A Study on the Effect of Patient Characteristics, Geographical Utilization, and Patient Outcomes for Total Pancreatectomy Alone and Total Pancreatectomy With Islet Autotransplantation in Patients With Pancreatitis in the United States.

Author information

1
From the Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH.
2
Division of Pediatric Endocrinology, University of Minnesota Medical School, Minneapolis, MN.
3
Department of Surgery, Cincinnati Children's Hospital, Cincinnati, OH.
4
Department of Surgery, University of Chicago, Chicago, IL.
5
Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
6
Division of Surgical Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
7
Division of Gastroenterology and Hepatology, Johns Hopkins Medical Center, Baltimore, MD.
8
Department of Pediatrics.
9
Department of Surgery, University of Minnesota Medical School, Minneapolis, MN.
10
Islet Cell Laboratory, Baylor Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX.
11
Division of Biostatistics, University of Minnesota, Minneapolis, MN.
12
Department of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
13
Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Medical School, Minneapolis, MN.
14
Division of Transplant Surgery, The University of Pennsylvania, Philadelphia, PA.
15
Department of Surgery, Medical University of South Carolina, Charleston, SC.
16
Department of Pediatrics, Cincinnati Children's Hospital.
17
Department of Surgery, University of Cincinnati, Cincinnati, OH.
18
Department of Surgery, University of California-San Francisco, San Francisco, CA.
19
Department of Surgery, University of Louisville, Louisville, KY.

Abstract

OBJECTIVES:

A selective therapy for pancreatitis is total pancreatectomy and islet autotransplantation. Outcomes and geographical variability of patients who had total pancreatectomy (TP) alone or total pancreatectomy with islet autotransplantation (TPIAT) were assessed.

METHODS:

Data were obtained from the Healthcare Cost and Utilization Project National Inpatient Sample database. Weighed univariate and multivariate analyses were performed to determine the effect of measured variables on outcomes.

RESULTS:

Between 2002 and 2013, there were 1006 TP and 825 TPIAT in patients with a diagnosis of chronic pancreatitis, and 1705 TP and 830 TPIAT for any diagnosis of pancreatitis. The majority of the TP and TPIAT were performed in larger urban hospitals. Costs were similar for TP and TPIAT for chronic pancreatitis but were lower for TPIAT compared with TP for any type of pancreatitis. The trend for TP and TPIAT was significant in all geographical areas during the study period.

CONCLUSIONS:

There is an increasing trend of both TP and TPIAT. Certain groups are more likely to be offered TPIAT compared with TP alone. More data are needed to understand disparities and barriers to TPIAT, and long-term outcomes of TPIAT such as pain control and glucose intolerance need further study.

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