title: Total pancreatectomy for pancreatic carcinoma: evaluation of safety and efficacy.
abstract: OBJECTIVE
  To determine the safety and the efficacy of total pancreatectomy for the curative treatment of pancreatic carcinoma.
  
  
  METHODS
  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.affiliation: Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Kitagawa
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Ishii
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Chohei
authors.initials: C
authors.lastname: Sakakura
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Kokuba
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Sonoyama
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D000930:Antidiarrheals / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D016063:Blood Loss, Surgical; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007564:Japan; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D054328:Proton Pump Inhibitors / Q000008:administration & dosage; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000930:Antidiarrheals; D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D054328:Proton Pump Inhibitors; C517652:hemoglobin A1c protein, human