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Hepato-gastroenterology 2012-May

Total pancreatectomy for pancreatic carcinoma: evaluation of safety and efficacy.

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Maki Kitagawa
Hisashi Ikoma
Toshiya Ochiai
Hiromichi Ishii
Atsushi Shiozaki
Yoshiaki Kuriu
Masayoshi Nakanishi
Daisuke Ichikawa
Kazuma Okamoto
Hitoshi Fujiwara

Sleutelwoorden

Abstract

OBJECTIVE

To determine the safety and the efficacy of total pancreatectomy for the curative treatment of pancreatic carcinoma.

METHODS

Retrospective analysis was performed using 10 patients receiving total pancreatectomy.

RESULTS

The median duration of the operative procedure was 8.7 hours and the median estimated blood loss was 2,700mL. Seven patients developed postoperative complications, including infections in 5 cases. There was no death associated with the operative procedure itself. Median period of postoperative hospital stay was 55 days. Anastomotic ulcer was prevented by administration of proton- pump inhibitors. Blood glucose level was well controlled by subcutaneous injection of sliding scale insulin during the postoperative period and the dosage of insulin required was 0.45±0.13units/kg body weight/ day at the time of discharge. The mean HbA1c level at 3 months after the operation was 6.1%. Four patients needed medication with anti-diarrheal drugs.

CONCLUSIONS

Total pancreatectomy could be performed safely and postoperative daily performance was reasonable with effective medication. We suggest that total pancreatectomy should be considered for the treatment of pancreatic carcinoma when the patient status is appropriate for this procedure.

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