title: Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center.
abstract: OBJECTIVE
  To identify the current indications and outcomes of total pancreatectomy at a high-volume center.
  
  
  METHODS
  A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed.
  
  
  RESULTS
  One hundred and three patients underwent total pancreatectomy for indications including: Pancreatic ductal adenocarcinoma (n= 42, 40.8%), intraductal papillary mucinous neoplasms (n= 40, 38.8%), chronic pancreatitis (n= 8, 7.8%), pancreatic neuroendocrine tumors (n= 7, 6.8%), and miscellaneous (n= 6, 5.8%). The mean age was 66.2 years, and 59 (57.3%) were female. Twenty-four patients (23.3%) underwent a laparoscopic total pancreatectomy. Splenic preservation and portal vein resection and reconstruction were performed in 24 (23.3%) and 18 patients (17.5%), respectively. The 90 d major complications, readmission, and mortality rates were 32%, 17.5%, and 6.8% respectively. The 1-, 3-, 5-, and 7-year survival for patients with benign indications were 84%, 82%, 79.5%, and 75.9%, and for malignant indications were 64%, 40.4%, 34.7% and 30.9%, respectively.
  
  
  CONCLUSIONS
  Total pancreatectomy, including laparoscopic total pancreatectomy, appears to be an appropriate option for selected patients when treated at a high-volume pancreatic center and through a multispecialty approach.
authors.affiliation: Hazem M Zakaria, Department of Hepatopancreatobiliary and Liver Transplantation Surgery, National Liver Institute, Menoufia University, Al-Minufya 22732, Egypt.
authors.forename: Hazem M
authors.initials: HM
authors.lastname: Zakaria
authors.affiliation: Hazem M Zakaria, Department of Hepatopancreatobiliary and Liver Transplantation Surgery, National Liver Institute, Menoufia University, Al-Minufya 22732, Egypt.
authors.forename: John A
authors.initials: JA
authors.lastname: Stauffer
authors.affiliation: Hazem M Zakaria, Department of Hepatopancreatobiliary and Liver Transplantation Surgery, National Liver Institute, Menoufia University, Al-Minufya 22732, Egypt.
authors.forename: Massimo
authors.initials: M
authors.lastname: Raimondo
authors.affiliation: Hazem M Zakaria, Department of Hepatopancreatobiliary and Liver Transplantation Surgery, National Liver Institute, Menoufia University, Al-Minufya 22732, Egypt.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Woodward
authors.affiliation: Hazem M Zakaria, Department of Hepatopancreatobiliary and Liver Transplantation Surgery, National Liver Institute, Menoufia University, Al-Minufya 22732, Egypt.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Wallace
authors.affiliation: Hazem M Zakaria, Department of Hepatopancreatobiliary and Liver Transplantation Surgery, National Liver Institute, Menoufia University, Al-Minufya 22732, Egypt.
authors.forename: Horacio J
authors.initials: HJ
authors.lastname: Asbun
keywords: Intraductal papillary mucinous neoplasms; Laparoscopic total pancreatectomy; Laparoscopy; Pancreas cancer; Pancreas cyst; Pancreatic ductal adenocarcinoma