Jorg Kleeff, Melena D Bellin, David C Whitcomb, Tooru Shimosegawa, Andrea R G Sheel, John P Neoptolemos, John A Windsor, Jens Werner, Jaimie D Nathan, Marlon F Levy, Johanna Laukkarinen, Maisam Abu-El-Haija, Thilo Hackert, Helmut Friess, Martin L Freeman, Vikas Dudeja, Ashley R Dennison, Ihsan Ekin Demir, Marco Del Chiaro, Marc G Besselink, Gregory J Beilman, Takayuki Anazawa
Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2021;20(4):762-771
PMID: 32327370
BACKGROUND
Advances in our understanding of total pancreatectomy with islet autotransplantation (TPIAT) have been made. We aimed to define indications and outcomes of TPIAT.
METHODS
Expert physician-scientists from North America, Asia, and Europe reviewed the literature to address six questions selected by the writing group as high priority topics. A consensus was reached by voting on statements generated from the review.
RESULTS
Consensus statements were voted upon with strong agreement reached that (Q1) TPIAT may improve quality of life, reduce pain and opioid use, and potentially reduce medical utilization; that (Q3) TPIAT offers glycemic benefit over TP alone; that (Q4) the main indication for TPIAT is disabling pain, in the absence of certain medical and psychological contraindications; and that (Q6) islet mass transplanted and other disease features may impact diabetes mellitus outcomes. Conditional agreement was reached that (Q2) the role of TPIAT for all forms of CP is not yet identified and that head-to-head comparative studies are lacking, and that (Q5) early surgery is likely to improve outcomes as compared to late surgery.
CONCLUSIONS
Agreement on TPIAT indications and outcomes has been reached through this working group. Further studies are needed to answer the long-term outcomes and maximize efforts to optimize patient selection.
Copyright © 2020 IAP and EPC. Published by Elsevier B.V. All rights reserved.
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