Total pancreatectomy for pancreatic carcinoma: evaluation of safety and efficacy.

Abstract

BACKGROUND/AIMS:

To determine the safety and the efficacy of total pancreatectomy for the curative treatment of pancreatic carcinoma.

METHODOLOGY:

Retrospective analysis was performed using 10 patients receiving total pancreatectomy.

RESULTS:

The median duration of the operative procedure was 8.7 hours and the median estimated blood loss was 2,700mL. Seven patients developed postoperative complications, including infections in 5 cases. There was no death associated with the operative procedure itself. Median period of postoperative hospital stay was 55 days. Anastomotic ulcer was prevented by administration of proton- pump inhibitors. Blood glucose level was well controlled by subcutaneous injection of sliding scale insulin during the postoperative period and the dosage of insulin required was 0.45±0.13units/kg body weight/ day at the time of discharge. The mean HbA1c level at 3 months after the operation was 6.1%. Four patients needed medication with anti-diarrheal drugs.

CONCLUSIONS:

Total pancreatectomy could be performed safely and postoperative daily performance was reasonable with effective medication. We suggest that total pancreatectomy should be considered for the treatment of pancreatic carcinoma when the patient status is appropriate for this procedure.

• Authors: Maki Kitagawa, Hisashi Ikoma, Toshiya Ochiai, Hiromichi Ishii, Atsushi Shiozaki, Yoshiaki Kuriu, Masayoshi Nakanishi, Daisuke Ichikawa, Kazuma Okamoto, Hitoshi Fujiwara, Chohei Sakakura, Yukihito Kokuba, Teruhisa Sonoyama, Eigo Otsuji
• Journal: Hepato-gastroenterology (Hepatogastroenterology) Vol. 59 Issue 115 Pg. 907-10 (May 2012) ISSN: 0172-6390 [Print] Greece
• PMID: 22469740 (Publication Type: Journal Article)

Chemical References

• Antidiarrheals
• Biomarkers
• Blood Glucose
• Glycated Hemoglobin A
• Hypoglycemic Agents
• Insulin
• Proton Pump Inhibitors
• hemoglobin A1c protein, human

Topics

• Aged
• Antidiarrheals (therapeutic use)
• Biomarkers (blood)
• Blood Glucose (drug effects, metabolism)
• Blood Loss, Surgical
• Carcinoma (pathology, surgery)
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Hypoglycemic Agents (administration & dosage)
• Insulin (administration & dosage)
• Japan
• Length of Stay
• Male
• Middle Aged
• Pancreatectomy (adverse effects)
• Pancreatic Neoplasms (pathology, surgery)
• Postoperative Complications (etiology, prevention & control)
• Proton Pump Inhibitors (administration & dosage)
• Retrospective Studies
• Time Factors
• Treatment Outcome