Laparoscopic total pancreatectomy with islet autotransplantation (L-TPIAT) is a feasible alternative treatment for patients with chronic pancreatitis (CP), conclude the authors of a new case series published in JAMA Surgery .
The authors have presented results from their first 20 patients and say L-TPIAT resulted in shorter hospital stay, less need for opioids and fewer complications, compared with open or robotic-assisted total pancreatectomy with islet autotransplantation. The average operating time was 493 minutes, and islet isolation took an average of 185 minutes. The average decrease in pain score for all patients postoperatively was 33.25, on a scale from 0 to 100.
Writing in JAMA Surgery, the authors said that while L-TPIAT tends to be considered after medical, endoscopic, and traditional surgical approaches have failed, it should be considered earlier given that early surgical intervention of two to three years or less is associated with improved pain control in patients with CP.
“Chronic pancreatitis can be a very painful and debilitating condition. Careful patient selection can match the right candidates to this new minimally invasive surgical therapy,” said senior author and professor of surgery at the Johns Hopkins University School of Medicine, Dr Martin Makary.