Total pancreatectomy: indications, operative technique, and postoperative sequelae.

摘要: Total pancreatectomy has been used to treat both benign and malignant disease of the pancreas, but its use limited by concerns about management apancreatic state with attendant total endocrine exocrine insufficiency. Here, we review indications for pancreatectomy, operative technique, improvements in postoperative patients. remains a viable option treatment intractable pain associated chronic pancreatitis, multicentric or extensive neuroendocrine tumors, patients familial pancreatic cancer premalignant lesions, intraductal papillary mucinous neoplasia diffuse ductal involvement invasive disease. Improvements include auto-islet cell transplantation, advances insulin formulations, glucagon rescue therapy which allow much tighter control blood glucose than previously possible. This markedly lessens risk life-threatening hypoglycemia decreases long-term complications, resulting improved quality life these