Outcome after pancreatectomy and islet autotransplantation in a pediatric population
Outcome after pancreatectomy and islet autotransplantation in a pediatric population
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DOI：
10.1097/mpg.0b013e31815cbaf9
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发表时间：
2008-07-01
影响因子：
2.9
通讯作者：
Sutherland, David E. R.
中科院分区：
文献类型：
--
作者：
Bellin, Melena D.;Carlson, Annelisa M.;Sutherland, David E. R.
目的：对小儿慢性胰腺炎行胰腺切除术和自体胰岛移植术后的结果知之甚少。在这项研究中，我们的文件疼痛控制和代谢过程后，此程序在儿科population.Materials和方法：我们回顾了24例患者的病历18岁或以下谁接受了胰腺切除术与胰岛自体移植在明尼苏达大学从1989年7月至2006年6月。患者和/或其父母被邀请参加后续电话调查。主要结果指标是随访时的麻醉剂和胰岛素使用情况。我们比较了在青春期前接受手术的患者的结局（2000个胰岛当量/kg和既往无胰腺手术（P = 0.011））。preadolescents不太可能需要慢性麻醉治疗在后续（P = 0.05），更有可能维持移植功能（P = 0.02）与青少年相比，结论：胰腺切除术可以减轻疼痛的儿童慢性胰腺炎患者，大多数可以退出麻醉剂。胰岛自体移植可以预防或减轻约四分之三患者的糖尿病严重程度。结果目标的达成比例，年龄较小的儿童比年龄较大的儿童。
Objectives: Little is known regarding outcomes after pancreatectomy and islet autotransplantation for chronic pancreatitis in pediatric patients. In this study, we document pain control and metabolic course after this procedure in a pediatric population.Materials and Methods: We reviewed medical records for 24 patients 18 years old or younger who underwent pancreatectomy with islet autotransplantation at the University of Minnesota from July 1989 through June 2006. Patients and/or their parents were invited to participate in a follow-up telephone survey. Primary outcome measures were narcotics and insulin use at follow-up. We compared outcomes in patients undergoing surgery as preadolescents (2000 islet equivalents per kilogram and lack of prior pancreatic surgery (P=0.011). Preadolescents were less likely to require chronic narcotic therapy at follow-up (P=0.05) and were more likely to maintain graft function (P=0.02) compared with adolescents.Conclusions: Pancreatectomy can relieve pain in pediatric patients with chronic pancreatitis and the majority can withdraw from narcotics. Islet autotransplantation can prevent or reduce the severity of diabetes in about three fourths of patients. Outcome goals were reached in a higher proportion of younger than older children.