LONG-TERM RESULTS OF PANCREATIC RESECTION AND SEGMENTAL PANCREATIC AUTOTRANSPLANTATION FOR CHRONIC-PANCREATITIS

Thirteen patients who underwent extensive pancreatic resection and segmental autotransplantation and who have a median follow-up of 62 months are presented. Eleven patients had technically successful grafts. Three of six patients who underwent total pancreatectomy and three of five patients who underwent near-total resection remain insulin-independent. Those patients who require insulin require small dose and have stable diabetes. Pain has recurred in 7 of the 11 patients who underwent distal subtotal resection; 5 of them required pancreatoduodenectomy and completion pancreatectomy for pain relief. Because of the high rate of recurrence of pain after distal resection, we favor pancreatoduodenectomy as the initial procedure of choice. When distal near-total or total pancreatectomy is required, the addition of segmental autotransplanttation offers definitive, although at times transient, benefits in glucose homeostasis compared with no transplantation. © 1990 Reed Publishing USA.