Table of Contents
HPB Surgery
Volume 2010, Article ID 686702, 8 pages
http://dx.doi.org/10.1155/2010/686702
Clinical Study

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

1Department of General and Visceral Surgery, St. Josef Hospital, Ruhr University of Bochum, Gudrunstrasse 56, 44791 Bochum, Germany
2Department of Surgery, Katharinen Hospital Unna, 59423 Unna, Germany

Received 9 February 2010; Accepted 28 May 2010

Academic Editor: Attila Olah

Copyright © 2010 Monika S. Janot et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 = 9 4 8 ). Indications for TP were classified into 4 groups: tumors of advanced stage, 𝑛 = 2 3 (36.5%), technical problems due to soft pancreatic tissue, 𝑛 = 1 8 (28.6%), troubles due to perioperative surgical complications, 𝑛 = 1 5 (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.