Indications and Early Outcomes for Total Pancreatectomy at a High-Volume Pancreas Center

• Published in: HPB Surgery Vol. 2010; no. 2010; pp. 52 - 59
• Main Authors: Janot, Monika S, Belyaev, Orlin, Kersting, Sabine, Chromik, Ansgar M, Seelig, Matthias H, Sülberg, Dominique, Mittelkötter, Ulrich, Uhl, Waldemar H
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Limiteds 2010; Hindawi Puplishing Corporation; Hindawi Publishing Corporation
• Subjects: Adult; Aged; Aged, 80 and over; Clinical Study; Female; Humans; Male; Middle Aged; Pancreatectomy - mortality; Pancreatic Diseases - surgery; Treatment Outcome
• ISSN: 0894-8569; 1607-8462
• DOI: 10.1155/2010/686702

Background. This study aimed to analyse the most common current indications for total pancreatectomy (TP) at a high-volume pancreas center. Method. Prospectively collected data on indications and short-term outcome of all TP's performed from January 2004 until June 2008 were analysed. Results. The total pancreatectomies (TP) were 63, i.e., 6.7% of all pancreatic procedures (n=948). Indications for TP were classified into 4 groups: tumors of advanced stage, n=23 (36.5%), technical problems due to soft pancreatic tissue, n=18 (28.6%), troubles due to perioperative surgical complications, n=15 (23.8%), and therapy-resistant pain due to chronic pancreatitis, n=7 (11.1%). Surgical complications occurred in 23 patients (36.5%). The mortality in elective TP was 6.25%. Median postoperative stay was 21 days. Mortality, morbidity and the other perioperative parameters differed substantially according to the indication for pancreatectomy. Conclusion. Total pancreatectomy is definitely indicated for a limited range of elective and emergency situations. Indications can be: size or localisation of pancreatic tumor, trouble, technical diffuculties and therapy-refractory pain in chronic pancreatitis. A TP due to perioperative complications (troubles) after pancreatic resections is doomed by extremely high morbidity and mortality and should be avoided.