Pylorus-preserving total pancreatectomy and segmental pancreas autotransplantation.
12 patients affected by periampullary neoplasms underwent surgery consisting of modified pylorus-preserving total pancreatectomy. In 8 of these patients, a segmental pancreas autotransplantation was performed by anastomosing the splenic to the femoral vessels in the Scarpa's triangle. The pancreas was treated by irradiation to inhibit the exocrine function. Gastric emptying was studied in 9 survivors by upper gastrointestinal barium series. In 6 patients gastric emptying and pyloric function were also evaluated by radionuclide studies. In 3 patients the transplanted pancreas had to be removed within the second postoperative week because of graft thrombosis, infection or hemorrhage. In a mean follow-up of 16 months (range: 6-20 months) the remaining 5 transplants showed a good endocrine activity until the beginning of antiblastic treatment for hepatic metastasis (3 cases), pancreatic fibrosis (1 case) or the patient's death (2 case). At present no graft is still functioning.
Stipa
S
S
V Clinica Chirurgica, Università La Sapienza, Roma.
Tersigni
R
R
Cavallini
M
M
Stipa
F
F
D000328:Adult; D000368:Aged; D001659:Biliary Tract / Q000000981:diagnostic imaging; D001661:Biliary Tract Neoplasms / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D005260:Female; D005746:Gastric Emptying; D005934:Glucagon / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D011706:Pyloric Antrum / Q000503:physiopathology*; D011877:Radionuclide Imaging; D013270:Stomach / Q000000981:diagnostic imaging; D014182:Transplantation, Autologous
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D005934:Glucagon