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

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 f...

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Bibliographic Details
Published in:World journal of gastrointestinal surgery 2016-09, Vol.8 (9), p.634-642
Main Authors: Zakaria, Hazem M, Stauffer, John A, Raimondo, Massimo, Woodward, Timothy A, Wallace, Michael B, Asbun, Horacio J
Format: Article
Language:English
Subjects:
adenocarcinoma
cancer
cyst
ductal
Intraductal
Laparoscopy
mucinous
neoplasms
Laparoscopic
Pancreas
pancreatectomy
Pancreatic
papillary
Retrospective Study
total
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Summary: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.
ISSN:1948-9366
1948-9366
DOI:10.4240/wjgs.v8.i9.634