Indications and Early Outcomes for Total Pancreatectomy at a High-Volume Pancreas Center

摘要

Background. This study aimed to analyse the most common current indications for total pancreatectomy (TP) at a high-volume pancreas center.Method. Prospectively collected data on indications and short-term outcome of all TP's performed from January 2004 until June 2008 were analysed.Results. The total pancreatectomies (TP) were 63, i.e., 6.7% of all pancreatic procedures (n=948). Indications for TP were classified into 4 groups: tumors of advanced stage,n=23(36.5%), technical problems due to soft pancreatic tissue,n=18(28.6%), troubles due to perioperative surgical complications,n=15(23.8%), and therapy-resistant pain due to chronic pancreatitis,n=7(11.1%). Surgical complications occurred in 23 patients (36.5%). The mortality in elective TP was 6.25%. Median postoperative stay was 21 days. Mortality, morbidity and the other perioperative parameters differed substantially according to the indication for pancreatectomy.Conclusion.Total pancreatectomy is definitely indicated for a limited range of elective and emergency situations. Indications can be: size or localisation of pancreatictumor, trouble, technical diffuculties and therapy-refractory painin chronic pancreatitis.A TP due to perioperative complications (troubles) after pancreatic resections is doomed by extremely high morbidity and mortality and should be avoided.