Total pancreatectomy and islet autotransplantation in chronic pancreatitis: Recommendations from pancreasfest

Melena D. Bellin; Martin L. Freeman; Andres Gelrud; Adam Slivka; Alfred Clavel; Abhinav Humar; Sarah J. Schwarzenberg; Mark E. Lowe; Michael R. Rickels; David C. Whitcomb; Jeffrey B. Matthews

doi:10.1016/j.pan.2013.10.009

Total pancreatectomy and islet autotransplantation in chronic pancreatitis: Recommendations from pancreasfest

Melena D. Bellin, Martin L. Freeman, Andres Gelrud, Adam Slivka, Alfred Clavel, Abhinav Humar, Sarah J. Schwarzenberg, Mark E. Lowe, Michael R. Rickels, David C. Whitcomb, Jeffrey B. Matthews

Research output: Contribution to journal › Article › peer-review

106 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	27-35
Number of pages	9
Journal	Pancreatology
Volume	14
Issue number	1
DOIs	https://doi.org/10.1016/j.pan.2013.10.009
State	Published - 2014

Bibliographical note

Funding Information:
This work was supported in part by conference grants from the National Institute of Diabetes and Digestive and Kidney Diseases [ R13DK083216 (2009), R13DK088452 (2010), and R13DK09604 (2012)] and accredited physician education supported by Abbott Laboratories, Aptalis Pharma, Boston Scientific, Cook Medical, Lilly, and Olympus through the University of Pittsburgh office of Continuing Medical Education. The authors thank Ms. Michelle Kienholz, Ms. Joy Jenko Merusi, and Ms. Marianne Davis for their expert assistance with the editing of this manuscript.

Keywords

Diabetes mellitus
Hereditary pancreatitis
Pancreatic adenocarcinoma
Pancreatic cancer
Pancreatic surgery

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.pan.2013.10.009

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title = "Total pancreatectomy and islet autotransplantation in chronic pancreatitis: Recommendations from pancreasfest",

abstract = "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.",

keywords = "Diabetes mellitus, Hereditary pancreatitis, Pancreatic adenocarcinoma, Pancreatic cancer, Pancreatic surgery",

author = "Bellin, {Melena D.} and Freeman, {Martin L.} and Andres Gelrud and Adam Slivka and Alfred Clavel and Abhinav Humar and Schwarzenberg, {Sarah J.} and Lowe, {Mark E.} and Rickels, {Michael R.} and Whitcomb, {David C.} and Matthews, {Jeffrey B.}",

note = "Funding Information: This work was supported in part by conference grants from the National Institute of Diabetes and Digestive and Kidney Diseases [ R13DK083216 (2009), R13DK088452 (2010), and R13DK09604 (2012)] and accredited physician education supported by Abbott Laboratories, Aptalis Pharma, Boston Scientific, Cook Medical, Lilly, and Olympus through the University of Pittsburgh office of Continuing Medical Education. The authors thank Ms. Michelle Kienholz, Ms. Joy Jenko Merusi, and Ms. Marianne Davis for their expert assistance with the editing of this manuscript. ",

year = "2014",

doi = "10.1016/j.pan.2013.10.009",

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T1 - Total pancreatectomy and islet autotransplantation in chronic pancreatitis

T2 - Recommendations from pancreasfest

AU - Bellin, Melena D.

AU - Freeman, Martin L.

AU - Gelrud, Andres

AU - Slivka, Adam

AU - Clavel, Alfred

AU - Humar, Abhinav

AU - Schwarzenberg, Sarah J.

AU - Lowe, Mark E.

AU - Rickels, Michael R.

AU - Whitcomb, David C.

AU - Matthews, Jeffrey B.

N1 - Funding Information: This work was supported in part by conference grants from the National Institute of Diabetes and Digestive and Kidney Diseases [ R13DK083216 (2009), R13DK088452 (2010), and R13DK09604 (2012)] and accredited physician education supported by Abbott Laboratories, Aptalis Pharma, Boston Scientific, Cook Medical, Lilly, and Olympus through the University of Pittsburgh office of Continuing Medical Education. The authors thank Ms. Michelle Kienholz, Ms. Joy Jenko Merusi, and Ms. Marianne Davis for their expert assistance with the editing of this manuscript.

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

KW - Diabetes mellitus

KW - Hereditary pancreatitis

KW - Pancreatic adenocarcinoma

KW - Pancreatic cancer

KW - Pancreatic surgery

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Total pancreatectomy and islet autotransplantation in chronic pancreatitis: Recommendations from pancreasfest

Abstract

Bibliographical note

Keywords

UN SDGs

Publisher link

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