Clinical Reappraisal of Total Pancreatectomy for Pancreatic Disease

Background/Aims: In this study, it was reappraised the outcomes of total pancreatectomy (TP), retrospectively analyzing the safety of the procedures and factors associated with long-term survival. Methodology: Thirty-six consecutive patients underwent TP for pancreas disease at Kobe University Hospital. The outcomes of TP were evaluated, analyzing operation-related results (mortality, morbidity, survival and long-term outcomes) and oncological aspects. Results: Postoperative morbidity was 39% (14/36) and severe complications were anastomotic leak-age (n=3) and liver necrosis (n=1). In benign disease, 5-year survival was 50%, while 5-year survival in malignant disease was 22%. Postoperative glycosylated hemoglobin A1c (HbA1c) level was 7.8 +/- 1.2% at 6 months and 7.8 +/- 1.5% at 12 months after TP, respectively. Conclusion: TP is safely performed and the treatment option for selectively limited pancreatic cancer and intraductal papillary mucinous neoplasm of the pancreas (IPMN), when the patient condition permits and offers a chance of cure, although careful long-term medical care and follow-up are essential.