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Total pancreatectomy and islet cell autotransplantation is a proven surgical option in the appropriately selected patient with excellent short-term outcomes. Islet graft function is seen in most patients, though insulin independence attenuates over time and diabetic complications appear on long-term follow-up. Narcotic independence is achieved in most patients, with continued improvement on long-term follow-up. Quality-of-life is improved across the board, although mortality remains high in this population, with new insights into potential causes. Novel strategies to improve islet engraftment, disease monitoring of resulting comorbidities, and multi-disciplinary care pathways promise to further refine outcomes with this promising therapy.
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http://dx.doi.org/10.1016/j.yasu.2025.04.003 | DOI Listing |
Background: Costs associated with robotic pancreatectomy compared to those of open pancreatectomy are assumed to be high but are not well known, particularly during the initial implementation of the robot.
Study Design: Patients who underwent pancreatectomy for any diagnosis from January 2017 to August 2021 were identified retrospectively. Total hospital cost was calculated using intraoperative, inpatient, and outpatient costs within 30 days of surgery.
Surgery
September 2025
Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria; Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA; Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heide
Introduction: Very early recurrence in pancreatic ductal adenocarcinoma has been defined as recurrence ≤3 months after resection. Besides others, neoadjuvant treatment is delivered based on the assumption of preoperative eradication of micrometastasis as well as local downstaging. Prognostic factors of very early recurrence after neoadjuvant treatment remain largely unexplored.
View Article and Find Full Text PDFBackground: This systematic review and meta-analysis compared the intraoperative and postoperative outcomes of minimally invasive versus open distal pancreatectomy (ODP) in patients with pancreatic ductal adenocarcinoma (PDAC), which is a highly aggressive tumor with a high mortality rate. Surgical resection remains the only potentially curative treatment. Minimally invasive distal pancreatectomy (MIDP), including laparoscopic and robotic approaches, has gained popularity, although the evidence of its efficacy is limited.
View Article and Find Full Text PDFBackground/ Aim: Total pancreatectomy (TP) is an uncommon type of pancreatic resection, even at high-volume centers. The indications of a TP are not fully defined, and the outcomes are controversial. The study aims to assess the frequency of use, indications, and early outcomes of TP in a contemporary consecutive series of 36 patients.
View Article and Find Full Text PDFLangenbecks Arch Surg
September 2025
Department of General, Visceral and Vascular Surgery, Cantonal Hospital Baden, Baden, Switzerland.
Purpose: Pancreatic cancer usually affects the elderly as 70% of new diagnoses are made in patients older than 65 years. A risk factor for postoperative complications is the accumulation of comorbidities and functional decline, which together define "frailty". The aim of the current study was to assess the impact of frailty on postoperative recovery after pancreatic surgery.
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