Dixon Jennifer, DeLegge Mark, Morgan Katherine A, Adams David B
Medical University of South Carolina, Charleston, South Carolina, USA.
Am Surg. 2008 Aug;74(8):735-8. doi: 10.1177/000313480807400812.
Because of poor outcomes with traditional surgical management, total pancreatectomy with autologous islet transplantation (TPAIT) has been heralded as a breakthrough in the management of severe chronic pancreatitis intractable to medical management. To assess the impact of TPAIT on a pancreatobiliary disease-based center, a retrospective review and analysis of patients who underwent TPAIT after failing traditional surgical management was undertaken. Seven patients who underwent TPAIT were identified. Patient hospitalizations, emergency department visits, and clinic visits in the year pre- and post-TPAIT were tabulated. Average body weights and serum prealbumin were recorded during the year pre- and post-TPAIT. Based on the number of hospitalizations, clinic visits, and emergency department visits as an indicator of overall symptom severity, patients experienced an improvement in symptoms during the 12 months after TPAIT. Prealbumin values remained stable during the postoperative year. An observed decrease in weight suggests that other factors may be impacting the overall state of nutrition. The impact of TPAIT on the surgical management of chronic pancreatitis is limited in scope and benefit and continues to require careful analysis to identify appropriate candidates.
由于传统手术治疗效果不佳，自体胰岛移植全胰切除术（TPAIT）被誉为药物治疗难以控制的严重慢性胰腺炎治疗方面的一项突破。为评估TPAIT对一家以胰胆疾病为基础的中心的影响，对传统手术治疗失败后接受TPAIT的患者进行了回顾性研究和分析。确定了7例接受TPAIT的患者。列出了患者在TPAIT前后一年的住院情况、急诊就诊情况和门诊就诊情况。记录了TPAIT前后一年的平均体重和血清前白蛋白。以住院次数、门诊就诊次数和急诊就诊次数作为总体症状严重程度的指标，患者在TPAIT后的12个月内症状有所改善。术后一年前白蛋白值保持稳定。观察到的体重下降表明其他因素可能正在影响营养的总体状况。TPAIT对慢性胰腺炎手术治疗的影响在范围和益处方面有限，仍需要仔细分析以确定合适的候选者。
