Surgical techniques for total pancreatectomy and islet autotransplantation

Since the first successful total pancreatectomy with islet autotransplant (TPIAT) for the treatment of chronic pancreatitis some 40 years ago, the procedure has finally gained more widespread acceptance as the only reliable and effective treatment option to preserve endocrine pancreatic function and improve or cure the associated chronic pain syndrome. TPIAT is a complex procedure with a wide range of potential complications that are intrinsic to its two components: total pancreatectomy (TP) and islet autotransplantation (IAT). Mounting evidence in the literature supports TPIAT as an approach that can be done safely at centers with experience using open, laparoscopic, and/or robotic techniques with little or no morbidity and mortality. From the surgical perspective, the procedure is standardized and can be safely performed in adult and pediatric patients with chronic pancreatitis.