Ris Frédéric, Morel Philippe, Bosco Domenico, Thierry Berney
Clinique de chirurgie viscérale et de transplantation, HUG, 1211,Genève 14.
Rev Med Suisse. 2007 Jun 27;3(117):1627-8, 1630-1.
Patients with benign pancreatic disease (chronic pancreatitis, benign tumors) requiring extensive pancreatic surgery are subject to major metabolic changes. Many of them are at risk of developing diabetes. Surgical diabetes is very difficult to manage because of the lack of counter regulation mechanisms. Islet autotransplantation after isolation from the resected pancreas allows to avoid the development of surgical diabetes. Insulin independance can be maintained in 40 to 50% of the patients. Success rate depends on the number of isolated and transplanted islets and on the type of pancreatic disease. Procedures-related complications are rare, the most frequent being thrombosis of the portal vein, through which the islets are transplanted. Islet autotransplantation has been used successfully in chronic pancreatitis and benign tumors.
需要进行广泛胰腺手术的良性胰腺疾病(慢性胰腺炎、良性肿瘤)患者会发生重大代谢变化。他们中的许多人有患糖尿病的风险。由于缺乏反调节机制,手术性糖尿病很难控制。从切除的胰腺中分离后进行胰岛自体移植可避免手术性糖尿病的发生。40%至50%的患者可维持胰岛素非依赖状态。成功率取决于分离和移植的胰岛数量以及胰腺疾病的类型。与手术相关的并发症很少见,最常见的是胰岛移植所经门静脉的血栓形成。胰岛自体移植已成功应用于慢性胰腺炎和良性肿瘤。