Indications and Early Outcomes for Total Pancreatectomy at a High-Volume Pancreas Center

Abstract EN

Background.

This study aimed to analyse the most common current indications for total pancreatectomy (TP) at a high-volume pancreas center.

Method.

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.

Conclusion.

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.