Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2016; 8(9): 634-642
Published online Sep 27, 2016. doi: 10.4240/wjgs.v8.i9.634
Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center
Hazem M Zakaria, John A Stauffer, Massimo Raimondo, Timothy A Woodward, Michael B Wallace, Horacio J Asbun
Hazem M Zakaria, Department of Hepatopancreatobiliary and Liver Transplantation Surgery, National Liver Institute, Menoufia University, Al-Minufya 22732, Egypt
John A Stauffer, Horacio J Asbun, Department of Surgery, Mayo Clinic, Jacksonville, FL 32224, United States
Massimo Raimondo, Timothy A Woodward, Michael B Wallace, Department of Gastroenterology, Mayo Clinic, Jacksonville, FL 32224, United States
Author contributions: Zakaria HM contributed to the conception and design of the study, collection, analysis and interpretation of data, drafting and critical revision of the article, and generation/collection of figures; Stauffer JA contributed to the conception and design of the study, experiments, collection, analysis and interpretation of data, drafting and critical revision of the article and generation/collection of figures; Raimondo M, Woodward TA and Wallace MB contributed to the conception and design of the study, experiments, collection of data and critical revision of the article; Asbun HJ contributed to the conception and design of the study, experiments, collection, analysis and interpretation of data, drafting and critical revision of the article and generation/collection of figures; all authors gave final approval of the article.
Institutional review board statement: We conducted a retrospective study of 103 patients who underwent TP between March 1995 and December 2014 at Mayo Clinic in Jacksonville, Florida using data collected from an institutional review board-approved prospective database.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient gave informed consent for institutional data collection and sharing.
Conflict-of-interest statement: Dr. Zakaria, Dr. Stauffer, Dr. Raimondo, Dr. Woodward, Dr. Wallace and Dr. Asbun report no biomedical financial interests or potential conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: John A Stauffer, MD, Associate Professor of Surgery, Department of Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, United States. stauffer.john@mayo.edu
Telephone: +1-904-9532214 Fax: +1-904-9537368
Received: March 17, 2016
Peer-review started: March 20, 2016
First decision: April 19, 2016
Revised: May 3, 2016
Accepted: July 11, 2016
Article in press: July 13, 2016
Published online: September 27, 2016
Processing time: 192 Days and 12.3 Hours
Abstract
AIM

To identify the current indications and outcomes of total pancreatectomy at a high-volume center.

METHODS

A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed.

RESULTS

One hundred and three patients underwent total pancreatectomy for indications including: Pancreatic ductal adenocarcinoma (n = 42, 40.8%), intraductal papillary mucinous neoplasms (n = 40, 38.8%), chronic pancreatitis (n = 8, 7.8%), pancreatic neuroendocrine tumors (n = 7, 6.8%), and miscellaneous (n = 6, 5.8%). The mean age was 66.2 years, and 59 (57.3%) were female. Twenty-four patients (23.3%) underwent a laparoscopic total pancreatectomy. Splenic preservation and portal vein resection and reconstruction were performed in 24 (23.3%) and 18 patients (17.5%), respectively. The 90 d major complications, readmission, and mortality rates were 32%, 17.5%, and 6.8% respectively. The 1-, 3-, 5-, and 7-year survival for patients with benign indications were 84%, 82%, 79.5%, and 75.9%, and for malignant indications were 64%, 40.4%, 34.7% and 30.9%, respectively.

CONCLUSION

Total pancreatectomy, including laparoscopic total pancreatectomy, appears to be an appropriate option for selected patients when treated at a high-volume pancreatic center and through a multispecialty approach.

Keywords: Intraductal papillary mucinous neoplasms; Laparoscopic total pancreatectomy; Pancreatic ductal adenocarcinoma; Laparoscopy; Pancreas cyst; Pancreas cancer

Core tip: Treatment by total pancreatectomy for diseases of the pancreas has been gained acceptance and used more frequently by pancreatic surgeons. This review highlights a large volume single institutional experience with this operation demonstrating acceptable short-term and long-term outcomes.