title: Indications and early outcomes for total pancreatectomy at a high-volume pancreas center.
abstract: BACKGROUND
  This study aimed to analyse the most common current indications for total pancreatectomy (TP) at a high-volume pancreas center.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Total pancreatectomy is definitely indicated for a limited range of elective and emergency situations. Indications can be: size or localisation of pancreatic tumor, trouble, technical diffuculties and therapy-refractory pain in chronic pancreatitis. A TP due to perioperative complications (troubles) after pancreatic resections is doomed by extremely high morbidity and mortality and should be avoided.
authors.affiliation: Department of General and Visceral Surgery, St. Josef Hospital, Ruhr University of Bochum, Bochum, Germany.
authors.forename: Monika S
authors.initials: MS
authors.lastname: Janot
authors.forename: Orlin
authors.initials: O
authors.lastname: Belyaev
authors.forename: Sabine
authors.initials: S
authors.lastname: Kersting
authors.forename: Ansgar M
authors.initials: AM
authors.lastname: Chromik
authors.forename: Matthias H
authors.initials: MH
authors.lastname: Seelig
authors.forename: Dominique
authors.initials: D
authors.lastname: Sülberg
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mittelkötter
authors.forename: Waldemar H
authors.initials: WH
authors.lastname: Uhl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000401:mortality*; D010182:Pancreatic Diseases / Q000601:surgery*; D016896:Treatment Outcome