慢性胰腺炎胰腺切除术后自体胰岛移植现状

The current status of total pancreatectomy and islet autotransplantation for chronic pancreatitis

目前,胰腺切除后自体胰岛移植(IAT)主要用于治疗伴有顽固性疼痛的慢性胰腺炎。IAT可以防止或者减少由胰腺切除引起的外科糖尿病的发生,最大程度地保留胰腺内分泌功能。随着胰岛制备技术的不断提高,IAT的效果逐渐得到改善,且具有手术安全、术后不需免疫抑制剂、可有效防止糖尿病发生、改善预后等优点,应于国内推广开展。

Total pancreatectomy or near-total pancreatectomy with islet autotransplantation （IAT） is considered as the effective treatment for chronic pancreatitis （CP） with intractable pain. The main rationale was to relieve the pain of CP in patients in whom other measures had failed and, to preserve beta-cell mass and insulin secretory capacity, to prevent or minimize the otherwise inevitable surgical diabetes. IATs should been done after resection for benign pancreatic processes. With the progress of the islet isolation technique, clinical outcome of IAT has been improved significantly. Because IAT is safe, free of immunodepressant, and insulin independent to some extent, IAT always should be considered the primary surgical option for patients who have pancreatic resection of benign lesions.