Laparoscopy-Assisted Spleen-Preserving Distal Pancreatectomy for Living-Donor Pancreas Transplantation

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Abstract

Background Living pancreas transplantation plays an important role in the treatment of patients with severe type 1 diabetes. However, pancreatectomy is very invasive for the donor, and less-invasive surgical procedures are needed. Although some reports have described hand-assisted laparoscopic surgery for distal pancreatectomy in living-donor operations, less-invasive laparoscopy-assisted (LA) procedures are expected to increase the donor pool. We herein report the outcomes of four cases of LA spleen-preserving distal pancreatectomy (Warshaw technique [WT]) in living pancreas donors. Patients and Methods Four living pancreas donors underwent LA-WT at our institution from September 2010 to January 2013. All donors fulfilled the donor criteria established by the Japan Society for Pancreas and Islet Transplantation. Results The median donor age was 54 years. Two donors underwent left nephrectomy in addition to LA-WT for simultaneous pancreas–kidney transplantation. The median donor operation time for pancreatectomy was 340.5 minutes. The median pancreas warm ischemic time was 3 minutes. The median donor blood loss was 246 g. All recipients immediately achieved insulin independence. One donor required reoperation because of obstructive ileus resulting from a port-site hernia. Another donor developed a pancreatic fistula (International Study Group of Pancreatic Fistula grade B), which was controlled with conservative management. After a maximum follow-up of 73 months, no clinically relevant adverse events had occurred. These results were comparable with those of previous studies concerning living-donor pancreas transplantation. Conclusion The LA-WT is a safe and acceptable operation for living-donor pancreas transplantation.

Original languageEnglish
Pages (from-to)1133-1137
Number of pages5
JournalTransplantation Proceedings
Volume49
Issue number5
DOIs
Publication statusPublished - Jun 1 2017

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Pancreas Transplantation
Pancreatectomy
Living Donors
Laparoscopy
Spleen
Tissue Donors
Pancreatic Fistula
Pancreas
Hand-Assisted Laparoscopy
Warm Ischemia
Islets of Langerhans Transplantation
Ileus
Hernia
Blood Donors
Nephrectomy
Type 1 Diabetes Mellitus
Reoperation
Japan
Transplantation
Insulin

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

@article{776da5a1bd964664bbc0c609a4c1a9c0,
title = "Laparoscopy-Assisted Spleen-Preserving Distal Pancreatectomy for Living-Donor Pancreas Transplantation",
abstract = "Background Living pancreas transplantation plays an important role in the treatment of patients with severe type 1 diabetes. However, pancreatectomy is very invasive for the donor, and less-invasive surgical procedures are needed. Although some reports have described hand-assisted laparoscopic surgery for distal pancreatectomy in living-donor operations, less-invasive laparoscopy-assisted (LA) procedures are expected to increase the donor pool. We herein report the outcomes of four cases of LA spleen-preserving distal pancreatectomy (Warshaw technique [WT]) in living pancreas donors. Patients and Methods Four living pancreas donors underwent LA-WT at our institution from September 2010 to January 2013. All donors fulfilled the donor criteria established by the Japan Society for Pancreas and Islet Transplantation. Results The median donor age was 54 years. Two donors underwent left nephrectomy in addition to LA-WT for simultaneous pancreas–kidney transplantation. The median donor operation time for pancreatectomy was 340.5 minutes. The median pancreas warm ischemic time was 3 minutes. The median donor blood loss was 246 g. All recipients immediately achieved insulin independence. One donor required reoperation because of obstructive ileus resulting from a port-site hernia. Another donor developed a pancreatic fistula (International Study Group of Pancreatic Fistula grade B), which was controlled with conservative management. After a maximum follow-up of 73 months, no clinically relevant adverse events had occurred. These results were comparable with those of previous studies concerning living-donor pancreas transplantation. Conclusion The LA-WT is a safe and acceptable operation for living-donor pancreas transplantation.",
author = "S. Date and Hiroshi Noguchi and Keizo Kaku and K. Kurihara and Yoshihiro Miyasaka and Yasuhiro Okabe and Udai Nakamura and Ohtsuka Takao and Masafumi Nakamura",
year = "2017",
month = "6",
day = "1",
doi = "10.1016/j.transproceed.2017.03.037",
language = "English",
volume = "49",
pages = "1133--1137",
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TY - JOUR

T1 - Laparoscopy-Assisted Spleen-Preserving Distal Pancreatectomy for Living-Donor Pancreas Transplantation

AU - Date, S.

AU - Noguchi, Hiroshi

AU - Kaku, Keizo

AU - Kurihara, K.

AU - Miyasaka, Yoshihiro

AU - Okabe, Yasuhiro

AU - Nakamura, Udai

AU - Takao, Ohtsuka

AU - Nakamura, Masafumi

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Background Living pancreas transplantation plays an important role in the treatment of patients with severe type 1 diabetes. However, pancreatectomy is very invasive for the donor, and less-invasive surgical procedures are needed. Although some reports have described hand-assisted laparoscopic surgery for distal pancreatectomy in living-donor operations, less-invasive laparoscopy-assisted (LA) procedures are expected to increase the donor pool. We herein report the outcomes of four cases of LA spleen-preserving distal pancreatectomy (Warshaw technique [WT]) in living pancreas donors. Patients and Methods Four living pancreas donors underwent LA-WT at our institution from September 2010 to January 2013. All donors fulfilled the donor criteria established by the Japan Society for Pancreas and Islet Transplantation. Results The median donor age was 54 years. Two donors underwent left nephrectomy in addition to LA-WT for simultaneous pancreas–kidney transplantation. The median donor operation time for pancreatectomy was 340.5 minutes. The median pancreas warm ischemic time was 3 minutes. The median donor blood loss was 246 g. All recipients immediately achieved insulin independence. One donor required reoperation because of obstructive ileus resulting from a port-site hernia. Another donor developed a pancreatic fistula (International Study Group of Pancreatic Fistula grade B), which was controlled with conservative management. After a maximum follow-up of 73 months, no clinically relevant adverse events had occurred. These results were comparable with those of previous studies concerning living-donor pancreas transplantation. Conclusion The LA-WT is a safe and acceptable operation for living-donor pancreas transplantation.

AB - Background Living pancreas transplantation plays an important role in the treatment of patients with severe type 1 diabetes. However, pancreatectomy is very invasive for the donor, and less-invasive surgical procedures are needed. Although some reports have described hand-assisted laparoscopic surgery for distal pancreatectomy in living-donor operations, less-invasive laparoscopy-assisted (LA) procedures are expected to increase the donor pool. We herein report the outcomes of four cases of LA spleen-preserving distal pancreatectomy (Warshaw technique [WT]) in living pancreas donors. Patients and Methods Four living pancreas donors underwent LA-WT at our institution from September 2010 to January 2013. All donors fulfilled the donor criteria established by the Japan Society for Pancreas and Islet Transplantation. Results The median donor age was 54 years. Two donors underwent left nephrectomy in addition to LA-WT for simultaneous pancreas–kidney transplantation. The median donor operation time for pancreatectomy was 340.5 minutes. The median pancreas warm ischemic time was 3 minutes. The median donor blood loss was 246 g. All recipients immediately achieved insulin independence. One donor required reoperation because of obstructive ileus resulting from a port-site hernia. Another donor developed a pancreatic fistula (International Study Group of Pancreatic Fistula grade B), which was controlled with conservative management. After a maximum follow-up of 73 months, no clinically relevant adverse events had occurred. These results were comparable with those of previous studies concerning living-donor pancreas transplantation. Conclusion The LA-WT is a safe and acceptable operation for living-donor pancreas transplantation.

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