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The impact of surgical complications on the outcome of total pancreatectomy with islet autotransplantation.

Authors
  • Shahbazov, Rauf1
  • Naziruddin, Bashoo2
  • Salam, Osmaan3
  • Saracino, Giovanna4
  • Levy, Marlon F5
  • Beecherl, Ernest6
  • Onaca, Nicholas7
  • 1 Department of Surgery, Division of Transplantation, Upstate Medical University, 750 E. Adams Street, Syracuse, NY, 13210, USA. Electronic address: [email protected]
  • 2 Baylor Annette C. and Harold C. Simmons Transplant Institute, 3410 Worth Street, Suite 950, Dallas, TX, 75246, USA. Electronic address: [email protected]
  • 3 Islet Cell Laboratory, Baylor Scott and White Research Institute, 3812 Elm Street, Dallas, TX, 75226, USA. Electronic address: [email protected]
  • 4 Baylor Annette C. and Harold C. Simmons Transplant Institute, 3410 Worth Street, Suite 950, Dallas, TX, 75246, USA. Electronic address: [email protected]
  • 5 Department of Surgery, Hume-Lee Transplant Center, VCU Health, 1250 East Marshall Street, Richmond, VA, 23298, USA. Electronic address: [email protected]
  • 6 Baylor Annette C. and Harold C. Simmons Transplant Institute, 3410 Worth Street, Suite 950, Dallas, TX, 75246, USA. Electronic address: [email protected]
  • 7 Baylor Annette C. and Harold C. Simmons Transplant Institute, 3410 Worth Street, Suite 950, Dallas, TX, 75246, USA. Electronic address: [email protected]
Type
Published Article
Journal
American journal of surgery
Publication Date
Jan 01, 2020
Volume
219
Issue
1
Pages
99–105
Identifiers
DOI: 10.1016/j.amjsurg.2019.04.007
PMID: 31023550
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Total pancreatectomy with islet autotransplantation is a promising treatment for refractory chronic pancreatitis. We analyzed postoperative complications in 83 TPIAT patients and their impact on islet graft function. We examined patient demographics, preoperative risk factors, intraoperative variables, and 30- and 90-day postoperative morbidity and mortality. Daily insulin requirement, HbA1c, C-peptide levels, and narcotic requirements were analyzed before and after surgery. Adverse events were recorded, with postoperative complications graded according to the Clavien-Dindo classification. There was no mortality in this patient group. Postoperative complications occurred in 38 patients (45.7%). Patients with postoperative complications were readmitted significantly more often within 30 days (p = 0.01) and 90 days posttransplant (p < 0.0003) and had a significantly longer hospital stay (p = 0.004) and intensive care unit stay (p = 0.001). Insulin dependence and graft function assessed by HbA1c, C-Peptide and insulin requirements did not differ significantly by these complications. Postoperative complications after TPIAT are associated with longer hospital and intensive care unit stay and with readmission; however, the surgical complications do not affect islet graft function. Copyright © 2019 Elsevier Inc. All rights reserved.

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