• Gregory C Wilson, Jeffrey M Sutton, Milton T Smith, Nathan Schmulewitz, Marzieh Salehi, Kyuran A Choe, John E Brunner, Daniel E Abbott, Jeffrey J Sussman, and Syed A Ahmad.
• Department of Surgery, University of Cincinnati Pancreatic Disease Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
• HPB (Oxford). 2015 Mar 1; 17 (3): 232-8.

ObjectivesPatients with minimal-change chronic pancreatitis (MCCP) are traditionally managed medically with poor results. This study was conducted to review outcomes following total pancreatectomy with islet cell autotransplantation (TP/IAT) as the initial surgical procedure in the treatment of MCCP.MethodsAll patients submitted to TP/IAT for MCCP were identified for inclusion in a single-centre observational study. A retrospective chart review was performed to identify pertinent preoperative, perioperative and postoperative data.ResultsA total of 84 patients with a mean age of 36.5 years (range: 15-60 years) underwent TP/IAT as the initial treatment for MCCP. The most common aetiology of chronic pancreatitis in this cohort was idiopathic (69.0%, n = 58), followed by aetiologies associated with genetic mutations (16.7%, n = 14), pancreatic divisum (9.5%, n = 8), and alcohol (4.8%, n = 4). The most common genetic mutations pertained to CFTR (n = 9), SPINK1 (n = 3) and PRSS1 (n = 2). Mean ± standard error of the mean preoperative narcotic requirements were 129.3 ± 18.7 morphine-equivalent milligrams (MEQ)/day. Overall, 58.3% (n = 49) of patients achieved narcotic independence and the remaining patients required 59.4 ± 10.6 MEQ/day (P < 0.05). Postoperative insulin independence was achieved by 36.9% (n = 31) of patients. The Short-Form 36-Item Health Survey administered postoperatively demonstrated improvement in all tested quality of life subscales.ConclusionsThe present report represents one of the largest series demonstrating the benefits of TP/IAT in the subset of patients with MCCP.© 2014 International Hepato-Pancreato-Biliary Association.

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