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  • Title: [A clinical report of vascularized segmental pancreatic autotransplantation in chronic pancreatitis].
    Author: Tamura K, Kin S, Ono K, Tarumi T, Nakagawa M, Nakase A.
    Journal: Nihon Geka Gakkai Zasshi; 1986 Jan; 87(1):111-7. PubMed ID: 3515159.
    Abstract:
    A vascularized segmental autotransplantation of distal 80% of the pancreas to the right iliopelvic space was successfully performed in a 51-year-old male who had alcoholic chronic pancreatitis. Distal 80% of the gland with severe calcified pancreatitic change was resected and prepared for transplantation by injecting the splenic artery with Ringer's lactate solution containing heparin, albumin and gabexate mecilate cooled to 4 degrees C. The spleen was removed from the specimen. An arteriovenous fistula was constructed at the tail. End-to-side anastomosis of spleno-external iliac veins was carried out after small fusiform resection of the iliac venous wall for the purpose of sufficient venous patency. End-to-end anastomosis of spleno-hypogastric arteries was done. The pancreatic stump was anastomosed to the ileum. Post-operatively, the pain completely resolved. Patency of the graft was demonstrated by angiography. Higher response of the C-peptide immunoreactivity on 75 g OGTT was found in the iliac vein on the transplanted side than in another peripheral vein. The exocrine pancreatic function diagnostant test showed 78.8% post-operatively (vs. 63.2% pre-operatively). Vascularized segmental pancreatic autotransplantation offers an excellent method of relieving pain with preservation of endocrine and exocrine functions in selected cases with chronic pancreatitis.
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