Duodenum- and spleen-preserving total pancreatectomy for end-stage chronic XXXX .

@entity1 @entity788 @entity6 @entity167 @entity294 @entity9727 @entity4306 @entity1017 @entity490 @entity158 @entity204
BACKGROUND: Total pancreatectomy may be warranted in @entity1 with advanced chronic @entity788 in whom partial resection has failed and in those with end-stage pancreatic function. A new operation, duodenum- and spleen-preserving total pancreatectomy, is described. METHODS: Nineteen consecutive @entity1 with chronic @entity788 who had duodenum- and spleen-preserving total pancreatectomy were studied. RESULTS: There were 15 @entity1 and four @entity1 with a median age of 40 (range 29-64) years. The aetiology was @entity167 misuse in nine, @entity4306 in five and idiopathic in five @entity1 . All @entity1 had chronic intractable @entity490 . Six had undergone pancreatic surgery previously and one had had multiple coeliac plexus blocks. There were ten postoperative complications in five @entity1 , and one @entity204 . The median hospital stay was 25 (range 10-84) days. There was a reduction in @entity158 (P < 0.001) and analgesic use (P < 0.001) after surgery, and @entity1017 was noted at 12 and 24 months (P < 0.001). Nine @entity1 required readmission to hospital, four because of surgical complications: adhesional obstruction in one, biliary stricture in two and @entity9727 in one. In the other five @entity1 (four of whom had long-standing pre-existing @entity6 ) readmission was for better control of @entity158 (three @entity1 ), @entity6 (two), and @entity6 -associated @entity294 (two) or gastropathy (one). CONCLUSION: Duodenum- and spleen-preserving total pancreatectomy has a role in selected @entity1 with medically intractable @entity158 from chronic @entity788 .
