Variables Associated with Islet Yield in Autologous Islet Cell Transplantation for Chronic Pancreatitis (Clinical Report)
Baylor University Medical Center Proceedings 2010, April, 23, 2
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Descrizione dell’editore
Chronic pancreatitis (CP) is a progressive inflammatory disease that destroys not only pancreatic acini but also islets in its late stage (1, 2). Episodes of severe abdominal pain are usually present in the natural course of CP, where both exocrine and endocrine function is also lost. Efforts such as decreasing smoking and alcohol use, taking oral pancreatic-enzyme supplements, and receiving endoscopic therapies such as sphincterotomy and stent placement are usually effective in managing pain and inhibiting disease progression; however, some patients have refractory or recurrent disease. Surgical options for CP treatment include drainage procedures such as the Puestow procedure and resections such as pancreaticoduodenectomy, distal pancreatectomy, or total pancreatectomy. These are effective in reducing severe abdominal pain but may not maintain endocrine function (3, 4). Total or near total pancreatectomy (TP) followed by autologous islet cell transplantation (AIT) was developed for both pain management and maintenance of pancreatic endocrine function, especially glycemic control (5-7). A few institutes in the world have performed TP with AIT, since AIT requires special techniques for islet cell processing, and the effectiveness of this procedure has been reported (5).