Published online Jan 18, 2023. doi: 10.5500/wjt.v13.i1.10
Peer-review started: October 7, 2022
First decision: November 14, 2022
Revised: November 24, 2022
Accepted: December 23, 2022
Article in press: December 23, 2022
Published online: January 18, 2023
Debilitating abdominal pain and diabetes mellitus are hallmark clinical manifestations of chronic pancreatitis (CP). Current management strategies revolve around pain mitigation and treatment of endocrine failure. One available treatment option is total pancreatectomy with islet cell auto tran
Emerging data from multiple studies highlight that TP-IAT results in considerable pain relief and insulin independence; however, systemic evidence from high-quality studies is limited.
We performed a systemic review and meta-analysis to evaluate clinical outcomes such as pain control and glucose intolerance following TP-IAT.
A comprehensive literature search spanning Pubmed, EMBASE, and Cochrane databases was performed from inception to March 2019. Studies conducted on outcomes of TP-IAT in patients with CP were identified. Comprehensive meta-analysis software was used to extract and analyze data. The random-effects model was used for all variables. Heterogeneity was assessed using the I2 measure and Cochrane Q-statistic. Publication bias was assessed using Egger’s test.
Our meta-analysis evaluated a total of 1100 patients across 21 studies. We found that TI-IAT results in narcotic independence in over 50% of adult and pediatric patients with CP. IAT results in meaningful islet cell function with insulin independence noted in almost one-third of adults and nearly half of pediatric patients following surgery.
TP-IAT results in acceptable narcotic independence and preservation of beta cell function.
Long-term prospective studies with clear definitions of patient populations, surgical procedures, and post-surgical care are needed to definitively evaluate insulin and narcotic independence before and after surgery.