-
- Srinath Chinnakotla, Gregory J Beilman, Ty B Dunn, Melena D Bellin, Martin L Freeman, David M Radosevich, Mustafa Arain, Stuart K Amateau, J Shawn Mallery, Sarah J Schwarzenberg, Alfred Clavel, Joshua Wilhelm, R Paul Robertson, Louise Berry, Marie Cook, Bernhard J Hering, David E R Sutherland, and Timothy L Pruett.
- *Department of Surgery, University of Minnesota Medical School, Minneapolis, MN †Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN ‡Schulze Diabetes Institute, University of Minnesota Medical School, Minneapolis, MN §Department of Medicine, University of Minnesota Medical School, Minneapolis, MN ¶Pain Management, University of Minnesota Medical School, Minneapolis, MN.
- Ann. Surg. 2015 Oct 1;262(4):610-22.
ObjectiveOur objective was to analyze factors predicting outcomes after a total pancreatectomy and islet autotransplantation (TP-IAT).BackgroundChronic pancreatitis (CP) is increasingly treated by a TP-IAT. Postoperative outcomes are generally favorable, but a minority of patients fare poorly.MethodsIn our single-centered study, we analyzed the records of 581 patients with CP who underwent a TP-IAT. Endpoints included persistent postoperative "pancreatic pain" similar to preoperative levels, narcotic use for any reason, and islet graft failure at 1 year.ResultsIn our patients, the duration (mean ± SD) of CP before their TP-IAT was 7.1 ± 0.3 years and narcotic usage of 3.3 ± 0.2 years. Pediatric patients had better postoperative outcomes. Among adult patients, the odds of narcotic use at 1 year were increased by previous endoscopic retrograde cholangiopancreatography (ERCP) and stent placement, and a high number of previous stents (>3). Independent risk factors for pancreatic pain at 1 year were pancreas divisum, previous body mass index >30, and a high number of previous stents (>3). The strongest independent risk factor for islet graft failure was a low islet yield-in islet equivalents (IEQ)-per kilogram of body weight. We noted a strong dose-response relationship between the lowest-yield category (<2000 IEQ) and the highest (≥5000 IEQ or more). Islet graft failure was 25-fold more likely in the lowest-yield category.ConclusionsThis article represents the largest study of factors predicting outcomes after a TP-IAT. Preoperatively, the patient subgroups we identified warrant further attention.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:

- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.