Total pancreatectomy and islet autotransplantation in chronic pancreatitis: Recommendations from PancreasFest
Total pancreatectomy and islet autotransplantation in chronic pancreatitis: Recommendations from PancreasFest
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DOI：
10.1016/j.pan.2013.10.009
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发表时间：
2014-01-01
期刊：
影响因子：
3.6
通讯作者：
Matthews, Jeffrey B.
中科院分区：
文献类型：
--
作者：
Bellin, Melena D.;Freeman, Martin L.;Matthews, Jeffrey B.
产品描述：全胰腺切除术联合胰岛自体移植（TPIAT）是一种用于治疗慢性胰腺炎严重并发症或极高风险胰腺癌的外科手术，同时降低重度糖尿病的风险。然而，缺乏关于适应症、禁忌症、评估、时机和随访的明确指导。方法：工作组审查了与TPIAT相关的医疗、心理和手术选择以及支持文献，以便在PancreasFest期间举行共识会议。结果：解决了需要临床评估和管理的五个主要领域：这些包括：1）TPIAT的适应症; 2）TPIAT的禁忌症; 3）最佳时机的程序; 4）需要一个多学科的团队和成员的角色; 5）终身管理TPIAP后的问题，包括糖尿病监测和营养evaluation.Conclusions：TPIAT是一种有效的方法管理慢性胰腺炎的致残并发症和胰腺癌的风险非常高的风险患者。需要由合格的多学科团队对候选患者进行仔细评估和长期管理。还确定了进一步研究的多项建议。版权所有（C）2013，IAP和EPC。由爱思唯尔印度出版，里德爱思唯尔印度私人有限公司的一个部门。保留所有权利。
Description: Total pancreatectomy with islet autotransplantation (TPIAT) is a surgical procedure used to treat severe complications of chronic pancreatitis or very high risk of pancreatic cancer while reducing the risk of severe diabetes mellitus. However, clear guidance on indications, contraindications, evaluation, timing, and follow-up are lacking.Methods: A working group reviewed the medical, psychological, and surgical options and supporting literature related to TPIAT for a consensus meeting during PancreasFest.Results: Five major areas requiring clinical evaluation and management were addressed: These included: 1) indications for TPIAT; 2) contraindications for TPIAT; 3) optimal timing of the procedure; 4) need for a multi-disciplinary team and the roles of the members; 5) life-long management issues following TPIAP including diabetes monitoring and nutrition evaluation.Conclusions: TPIAT is an effective method of managing the disabling complications of chronic pancreatitis and risk of pancreatic cancer in very high risk patients. Careful evaluation and long-term management of candidate patients by qualified multidisciplinary teams is required. Multiple recommendations for further research were also identified. Copyright (C) 2013, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.