title: [Combined liver-islet transplantation after epigastric exenteration in carcinoma of Vater's ampulla].
abstract: A 44 year old female underwent an upper abdominal exenteration because of an adenocarcinoma of the pancreas with liver metastases (T1 N1 M1). Reconstruction was performed by orthotopic liver transplantation and intraportal islet transplantation. Due to initial non function of the first liver graft, a second liver transplantation was performed. Thereafter, the patient received 375,000 islet equivalents of the primary liver donor in addition to 295,400 islet equivalents of another donor. Six months postoperatively, the patient is off insulin except irregular injections of 4-6 units of insulin to protect her from hyperglycemia after lunch. CT scans of the liver do not show any signs of tumor recurrence. Upper abdominal exenteration with consecutive islet transplantation offers a good method of reconstruction after radical surgery in the upper abdomen. The oncological aspects of the procedure have to be further investigated.
authors.affiliation: Chirurgische Universitätsklinik und Poliklinik Würzburg.
authors.forename: R
authors.initials: R
authors.lastname: Engemann
authors.forename: B J
authors.initials: BJ
authors.lastname: Hering
authors.forename: W
authors.initials: W
authors.lastname: Timmermann
authors.forename: H J
authors.initials: HJ
authors.lastname: Gassel
authors.forename: D
authors.initials: D
authors.lastname: Meyer
authors.forename: T
authors.initials: T
authors.lastname: Schang
authors.forename: H
authors.initials: H
authors.lastname: Brandhorst
authors.forename: D
authors.initials: D
authors.lastname: Brandhorst
authors.forename: R G
authors.initials: RG
authors.lastname: Bretzel
authors.forename: K
authors.initials: K
authors.lastname: Federlin
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D000328:Adult; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D004386:Duodenum / Q000473:pathology / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D006498:Hepatectomy; D006801:Humans; D007328:Insulin / Q000097:blood; D016381:Islets of Langerhans Transplantation / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D016031:Liver Transplantation / Q000473:pathology; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D010180:Pancreatectomy; D012086:Reoperation; D013156:Splenectomy; D016042:Transplantation, Heterotopic
chemical_list: D007328:Insulin
vernacular_title: Kombinierte Leber-Insel-Transplantation nach Oberbauchexenteration bei Papillencarcinom.