Pancreatitis Update (Part 2)

Our group received a very helpful update on pancreatitis from Maisam Abu-El-Haija (GI) and Jaime Nathan (surgery). These notes focus on the surgical perspective.  My notes may include some errors in transcription and errors of omission. Some pictures of the slides are included below as well.

Key points:

  • Several surgical procedures can be considered in chronic pancreatitis.  Prior surgical procedures, though, could reduce islet cells if TPIAT needed later.
  • TPIAT –Cincinnati experience: 17 cases in last 2 years.  Highly selected group. Operation time takes about 10 hours (or more).  GJ tube placed due to anticipated poor gastric emptying for 4-6 weeks. Fevers expected during 1st post-operative week due to systemic inflammatory response. ~15% of children remain on opioids after TPIAT, likely due to long-standing problems prior to TPIAT.
  • Post-TPIAT care: PERT, vitamins, insulin (may wean off).  During 1st year, anticoagulation, hydroxyurea/aspirin (if high platelets), and penicillin prophylaxis.  Prior to TPIAT, patients receive vaccines (due to anticipated splenectomy).

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