TY - JOUR AU - Maharjan, Dhiresh Kumar AU - Thapa, Prabin Bikram PY - 2020/09/30 Y2 - 2024/03/29 TI - Total pancreatectomy and salvage completion pancreatectomy-early and late outcomes without Islet cell auto-transplantation JF - Journal of Kathmandu Medical College JA - J. Kathmandu Med. Coll. VL - 9 IS - 3 SE - Original Research Article DO - UR - https://jkmc.com.np/ojs3/index.php/journal/article/view/1052 SP - 154-160 AB - <p><strong>Background: </strong><span style="font-weight: 400;">Total pancreatectomy was abandoned for decades because of high peri and post-operative morbidity and mortality. However, with better peri-operative outcome and post-operative management of exocrine and endocrine insufficiency, the hesitancy to perform total pancreatectomy has been disappearing.</span><strong>&nbsp;</strong></p><p><strong>Objectives: </strong><span style="font-weight: 400;">This study</span> <span style="font-weight: 400;">aims to study exocrinal and endocrinal effects of total pancreatectomy without Islet cell auto-transplantation and compare quality of life index among total pancreatectomy with Whipple patients.</span></p><p><strong>Methodology:</strong><span style="font-weight: 400;"> This is a prospectively conducted matched-pairs study. Group A underwent total or completion pancreatectomy after non-salvageable complications of Whipple operation. A matched-pairs analysis of quality of life index of these patients by using SF-36 questionnaire were compared with Group B who underwent Whipple operation during the same period of time, according to age, gender and pre-operative diagnosis.&nbsp;</span></p><p><strong>Results:</strong><span style="font-weight: 400;"> In four years (from February 2016 to February 2020), 160 patients underwent Whipple operation. The mean age of the patients was 59.9 +/-14.3 years. A total of nine patients underwent total pancreatectomy, among which two had per-operative decision of total pancreatectomy and seven had completion pancreatectomy. Median post-operative hospital stay was 11 days with two mortalities. Median follow-up of 12 months and quality of life index of total pancreatectomy patients were comparable to Whipple patients, although a few single quality of life items were reduced.&nbsp;</span></p><p><strong>Conclusion:</strong><span style="font-weight: 400;"> Exocrinal pancreatic supplements and long acting insulin have augmented control of diabetes despite of not using Islet cell auto-transplantation. Quality of life index of total pancreatectomy patients were comparable to that of Whipple patients. Hence, this study signifies the &nbsp; importance of completion pancreatectomy following non-salvageable complications after Whipple operation in order to save life.</span></p> ER -