Institutional Outcomes following Total Pancreatectomy with Islet Autotransplantation in Children

A retrospective review of TPIAT patients at a free-standing children’s hospital from April 2015 to April 2017 was performed to determine preoperative pancreatitis course and perioperative outcomes of TPIAT. Total pancreatectomy with islet autotransplantation (TPIAT) is used to treat debilitating chronic pancreatitis (CP) and acute recurrent pancreatitis (ARP) that has failed medical and endoscopic therapy. Chronic pancreatitis is a progressive fibroinflammatory injury that can result in endocrine and/or exocrine insufficiency, as well as in severe pain and impaired quality of life. The fibrotic pancreas is removed while the insulin-producing islets are isolated and transplanted back into the patient, usually into the liver via the portal vein. The procedure was performed with an open, pylorus-preserving approach with accompanied splenectomy and gastrojejunostomy tube placement. 16 patients received total pancreatecomies and 1 subtotal pancreatectomy performed. Following extraction of the fibrotic pancreas, an Islet isolation by enzymatic and mechanical digestion was performed using the Ricordi method