title: [Clinical evaluation of 21 cases of total pancreatectomy].
abstract: OBJECTIVE
  To evaluate the clinical outcome of 21 cases of total pancreatectomy.
  
  
  METHODS
  The clinical data of 21 cases of total pancreatectomy performed from April 2003 to June 2006 was retrospectively analyzed.
  
  
  RESULTS
  Among the 21 patients, 1 case combined with transverse colon resection, 1 case with total gastrectomy, 9 cases with portal-superior mesentery vein resection with end-to-end anastomosis, 9 cases with portal-superior mesentery vein resection and grafts implantation, 8 cases with concomitant celiac axis resection, 4 cases with concomitant celiac axis and common hepatic artery resection, 1 case with concomitant celiac axis, portal vein and superior mesentery artery resection and reconstruction. Complications occurred in 12 cases (57.1%) post the operation and 5 cases (23.8%) died in 30 days after the operation. Insulin was given at the dose of 18 - 28 U daily post operation and blood glucose was maintained normal effectively. Sixteen cases were followed-up and median survival was 9.2 months (1.2 - 13.0 months). The median survival of tubular adenocarcinoma and intraductal papillary mucinous neoplasms of the pancreas (IPMNs) were 7 months (1.2 - 9.0 months) and 11.3 months (10.0 - 13.0 months), respectively.
  
  
  CONCLUSIONS
  Total pancreatectomy could not improve survival and it increases the complications and death, but it could improve the quality of life. It's an operation of choice for IPMNs, but with pancreatic carcinoma, the warranty of operation should be considered. The blood glucose level could be maintained normal effectively after the operation.
authors.affiliation: Department of General Surgery, Zhong Shan Hospital, Fudan University, Shanghai 200032, China. dyjin@zshospital.net
authors.forename: Da-yong
authors.initials: DY
authors.lastname: Jin
authors.forename: Wen-hui
authors.initials: WH
authors.lastname: Lou
authors.forename: Dan-song
authors.initials: DS
authors.lastname: Wang
authors.forename: Tian-tao
authors.initials: TT
authors.lastname: Kuang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome