Bellin Melena D, Gelrud Andres, Arreaza-Rubin Guillermo, Dunn Ty B, Humar Abhinav, Morgan Katherine A, Naziruddin Bashoo, Rastellini Cristiana, Rickels Michael R, Schwarzenberg Sarah J, Andersen Dana K
*Departments of Pediatrics and Surgery, University of Minnesota Medical School, Minneapolis, MN †Department of Medicine, Pritzker School of Medicine, Center for Endoscopic Research and Therapeutics (CERT), Chicago, IL ‡Division of Diabetes, Endocrinology, and Metabolism and Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD §Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA ¶Department of Surgery, Medical University of South Carolina, Charleston, SC ‖Baylor Simmons Transplant Institute, Dallas, TX **Department of Surgery, University of Texas Medical Branch, Galveston, TX; and ††Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Ann Surg. 2015 Jan;261(1):21-9. doi: 10.1097/SLA.0000000000001059.
A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases focused on research gaps and opportunities in total pancreatectomy with islet autotransplantation (TPIAT) for the management of chronic pancreatitis. The session was held on July 23, 2014 and structured into 5 sessions: (1) patient selection, indications, and timing; (2) technical aspects of TPIAT; (3) improving success of islet autotransplantation; (4) improving outcomes after total pancreatectomy; and (5) registry considerations for TPIAT. The current state of knowledge was reviewed; knowledge gaps and research needs were specifically highlighted. Common themes included the need to identify which patients best benefit from and when to intervene with TPIAT, current limitations of the surgical procedure, diabetes remission and the potential for improvement, opportunities to better address pain remission, GI complications in this population, and unique features of children with chronic pancreatitis considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of chronic pancreatitis and total pancreatectomy outcomes and postsurgical diabetes outcomes was repeatedly emphasized.
由美国国立糖尿病、消化和肾脏疾病研究所主办的一次研讨会聚焦于全胰切除联合胰岛自体移植（TPIAT）治疗慢性胰腺炎的研究空白和机遇。该会议于2014年7月23日举行，分为5个环节：（1）患者选择、适应症和时机；（2）TPIAT的技术方面；（3）提高胰岛自体移植成功率；（4）改善全胰切除术后的结局；（5）TPIAT的登记考虑。回顾了当前的知识状态；特别强调了知识空白和研究需求。共同主题包括需要确定哪些患者最能从TPIAT中获益以及何时进行干预、手术程序的当前局限性、糖尿病缓解情况及改善潜力、更好解决疼痛缓解的机会、该人群的胃肠道并发症以及考虑接受TPIAT的慢性胰腺炎儿童的独特特征。反复强调需要建立一个多中心患者登记处，专门处理慢性胰腺炎的复杂性、全胰切除术后结局以及术后糖尿病结局。
