Total Pancreatectomy with Islet Autotransplantation: A Safer Alternative to Pancreaticoduodenectomy in High-risk Patients

In a prospective randomized trial, researchers compared pancreaticoduodenectomy (PD) and total pancreatectomy (TP) with islet autotransplantation (IAT) in high-risk patients. They found that TP-IAT had a lower morbidity rate and shorter postoperative stay compared to PD. PD was associated with a higher risk of complications, while TP-IAT had a higher risk of diabetes. However, most TP-IAT patients maintained good metabolic control and sustained c-peptide production over time. These results suggest that TP-IAT may be a viable alternative for high-risk patients.