Kesseli Samuel J, Smith Kerrington A, Gardner Timothy B
Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA.
Section of General Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Clin Transl Gastroenterol. 2015 Jan 29;6(1):e73. doi: 10.1038/ctg.2015.2.
Chronic pancreatitis (CP) is a debilitating disease that leads to varying degrees of pancreatic endocrine and exocrine dysfunction. One of the most difficult symptoms of CP is severe abdominal pain, which is often challenging to control with available analgesics and therapies. In the last decade, total pancreatectomy with autologous islet cell transplantation has emerged as a promising treatment for the refractory pain of CP and is currently performed at approximately a dozen centers in the United States. While total pancreatectomy is not a new procedure, the endocrine function-preserving autologous islet cell isolation and re-implantation have made the prospect of total pancreatectomy more acceptable to patients and clinicians. This review will focus on the current status of total pancreatectomy with autologous islet cell transplant including patient selection, technical considerations, and outcomes. As the procedure is performed at an increasing number of centers, this review will highlight opportunities for quality improvement and outcome optimization.
慢性胰腺炎（CP）是一种使人衰弱的疾病，会导致不同程度的胰腺内分泌和外分泌功能障碍。CP最棘手的症状之一是严重腹痛，使用现有的镇痛药和治疗方法往往难以控制。在过去十年中，全胰切除术联合自体胰岛细胞移植已成为治疗CP难治性疼痛的一种有前景的治疗方法，目前美国约有十几个中心开展此项手术。虽然全胰切除术并非新手术，但保留内分泌功能的自体胰岛细胞分离和再植入使全胰切除术更容易被患者和临床医生接受。本综述将聚焦于全胰切除术联合自体胰岛细胞移植的现状，包括患者选择、技术要点和治疗结果。随着越来越多的中心开展该手术，本综述将强调质量改进和优化治疗结果的机会。
