Distal Pancreatectomy and Islet Autotransplantation for Chronic Pancreatitis
| Autor: | George D. Zuidema, Denis G. Mehigan, John L. Cameron, Patrick J. Broe |
|---|---|
| Rok vydání: | 1981 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Portal venous pressure Islets of Langerhans Transplantation Transplantation Autologous Pancreatectomy Postoperative Complications medicine Humans Insulin Embolization Aged geography geography.geographical_feature_category Portal Vein business.industry Glucose Tolerance Test Middle Aged medicine.disease Islet Autotransplantation Surgery Liver Pancreatitis Chronic Disease Portal hypertension Female business Venous Pressure Research Article |
| Zdroj: | Annals of Surgery. 193:312-317 |
| ISSN: | 0003-4932 |
| DOI: | 10.1097/00000658-198103000-00010 |
| Popis: | Eight patients with chronic pancreatitis underwent 95% pancreatectomy and islet autotransplantation. The partially purified islet material was transplanted into the liver at the time of surgery via embolization into the portal vein. Hyperglycemia requiring insulin therapy developed in all patients immediately followed surgery. Six patients subsequently became normoglycemic an average of 28 days following the transplant (range: 8-90 days). Three of these patient have remained normoglycemic on a regular diet nine, 18, and 22 months following transplant. The other three redeveloped hyperglycemia and insulin dependency three, six, and eight months after surgery. Indirect measurement of functioning islet cell mass by intravenous glucose tolerance testing preoperatively was predictive of the outcome of the transplant. All patients developed portal hypertension (14-60 cm H2O) during tissue injection into the portal vein. Portal hypertension persisted in one patient and required treatment with a mesocaval shunt. The patient subsequently died of hepatic necrosis. Postoperative catheterization in four patients, three to 12 months posttransplant, revealed that portal pressure had returned to normal. Clinically, all seven surviving patients were improved following surgery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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