Perioperative Management of Patients Undergoing Total Pancreatectomy with/without Islet Cell Autotransplantation: A Single Center Experience
Total pancreatectomy (TP) and islet cell autotransplantation (IAT) are complex operations that require intensive postoperative monitoring with standardized protocols. There are few studies detailing immediate perioperative management. The purpose of this study was to describe the perioperative manag...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/12/3993 |
| _version_ | 1797594170709245952 |
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| author | Trista D. Reid Supradeep S. Madduri Chris B. Agala Chengyu Weng Sasha McEwan Chirag S. Desai |
| author_facet | Trista D. Reid Supradeep S. Madduri Chris B. Agala Chengyu Weng Sasha McEwan Chirag S. Desai |
| author_sort | Trista D. Reid |
| collection | DOAJ |
| description | Total pancreatectomy (TP) and islet cell autotransplantation (IAT) are complex operations that require intensive postoperative monitoring with standardized protocols. There are few studies detailing immediate perioperative management. The purpose of this study was to describe the perioperative management of post-pancreatectomy patients in the first week following surgery to guide clinicians in addressing salient points from different organ systems. This is a retrospective cohort review of prospectively collected data from September 2017 to September 2022 at a single institution, including patients 16 years and older who underwent TP or TPIAT for chronic pancreatitis. Patients were maintained on a heparin drip (TPIAT), insulin drip, and ketamine infusion. Primary outcomes were complications in the first 5 days following surgery and ICU length of stay (LOS). Secondary outcomes included overall LOS and mortality. Of 31 patients, 26 underwent TPIAT, and 5 underwent TP. Median ICU LOS was five days (IQR 4–6). The most common immediate postoperative complications were reintubation [<i>n</i> = 5 (16%)] and bleeding [<i>n</i> = 2 (6%)]. Median insulin drip use was 70 h (IQR 20–124). There was no mortality. Patients were extubated quickly and progressed well on the protocol. Immediate postoperative complications were generally minor and without long-term effects. |
| first_indexed | 2024-03-11T02:18:51Z |
| format | Article |
| id | doaj.art-d79434d140894b888cf9f095547d84e0 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T02:18:51Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d79434d140894b888cf9f095547d84e02023-11-18T10:59:30ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011212399310.3390/jcm12123993Perioperative Management of Patients Undergoing Total Pancreatectomy with/without Islet Cell Autotransplantation: A Single Center ExperienceTrista D. Reid0Supradeep S. Madduri1Chris B. Agala2Chengyu Weng3Sasha McEwan4Chirag S. Desai5Department of Surgery, Division of Trauma and Acute Care Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USASchool of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USASchool of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Surgery, Division of Trauma and Acute Care Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Surgery, Division of Abdominal Transplantation, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USATotal pancreatectomy (TP) and islet cell autotransplantation (IAT) are complex operations that require intensive postoperative monitoring with standardized protocols. There are few studies detailing immediate perioperative management. The purpose of this study was to describe the perioperative management of post-pancreatectomy patients in the first week following surgery to guide clinicians in addressing salient points from different organ systems. This is a retrospective cohort review of prospectively collected data from September 2017 to September 2022 at a single institution, including patients 16 years and older who underwent TP or TPIAT for chronic pancreatitis. Patients were maintained on a heparin drip (TPIAT), insulin drip, and ketamine infusion. Primary outcomes were complications in the first 5 days following surgery and ICU length of stay (LOS). Secondary outcomes included overall LOS and mortality. Of 31 patients, 26 underwent TPIAT, and 5 underwent TP. Median ICU LOS was five days (IQR 4–6). The most common immediate postoperative complications were reintubation [<i>n</i> = 5 (16%)] and bleeding [<i>n</i> = 2 (6%)]. Median insulin drip use was 70 h (IQR 20–124). There was no mortality. Patients were extubated quickly and progressed well on the protocol. Immediate postoperative complications were generally minor and without long-term effects.https://www.mdpi.com/2077-0383/12/12/3993islet autotransplantationtotal pancreatectomychronic pancreatitispostoperative managementintensive care |
| spellingShingle | Trista D. Reid Supradeep S. Madduri Chris B. Agala Chengyu Weng Sasha McEwan Chirag S. Desai Perioperative Management of Patients Undergoing Total Pancreatectomy with/without Islet Cell Autotransplantation: A Single Center Experience Journal of Clinical Medicine islet autotransplantation total pancreatectomy chronic pancreatitis postoperative management intensive care |
| title | Perioperative Management of Patients Undergoing Total Pancreatectomy with/without Islet Cell Autotransplantation: A Single Center Experience |
| title_full | Perioperative Management of Patients Undergoing Total Pancreatectomy with/without Islet Cell Autotransplantation: A Single Center Experience |
| title_fullStr | Perioperative Management of Patients Undergoing Total Pancreatectomy with/without Islet Cell Autotransplantation: A Single Center Experience |
| title_full_unstemmed | Perioperative Management of Patients Undergoing Total Pancreatectomy with/without Islet Cell Autotransplantation: A Single Center Experience |
| title_short | Perioperative Management of Patients Undergoing Total Pancreatectomy with/without Islet Cell Autotransplantation: A Single Center Experience |
| title_sort | perioperative management of patients undergoing total pancreatectomy with without islet cell autotransplantation a single center experience |
| topic | islet autotransplantation total pancreatectomy chronic pancreatitis postoperative management intensive care |
| url | https://www.mdpi.com/2077-0383/12/12/3993 |
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