학술논문

Current status of total pancreatectomy with islet autotransplantation for chronic and recurrent acute pancreatitis
Document Type
article
Source
Annals of Gastroenterological Surgery, Vol 8, Iss 3, Pp 401-412 (2024)
Subject
autologous transplantation
chronic pancreatitis
islet transplantation
pancreatectomy
quality of life
Surgery
RD1-811
Diseases of the digestive system. Gastroenterology
RC799-869
Language
English
ISSN
2475-0328
32233396
Abstract
Abstract Total pancreatectomy with islet autotransplantation (TPIAT) is an established and effective treatment modality for patients diagnosed with intractable chronic pancreatitis (CP) and recurrent acute pancreatitis (RAP). TPIAT primarily aims to manage debilitating pain leading to impaired quality of life among patients with CP or RAP, which can be successfully managed with medical, endoscopic, or surgical interventions. TPIAT is significantly successful in relieving pain associated with CP and improving health‐related quality of life outcomes. Furthermore, the complete loss of pancreatic endocrine function attributed to total pancreatectomy (TP) can be compensated by autologous islet transplantation (IAT). Patients receiving IAT can achieve insulin independence or can be less dependent on exogenous insulin compared with those receiving TP alone. Historically, TPIAT has been mainly used in the United States, and its outcomes have been improving due to technological advancements. Despite some challenges, TPIAT can be a promising treatment for patients with CP‐related intractable pain. Thus far, TPIAT is not commonly performed in Japan. Nevertheless, it may improve health‐related quality of life in Japanese patients with CP, similar to Western patients. This review article aimed to provide an overview of the indications, related procedures, and outcomes of TPIAT and to discuss future prospects in Japan.