Rainer W.G. Gruessner
The first successful total pancreatectomy with islet autotransplant (TPIAT) for the treatment of chronic pancreatitis was performed in 1977. Since then, the procedure continues to gain widespread acceptance as a reliable and effective treatment option to (1) improve or cure the associated chronic pain syndrome; (2) prevent the development of brittle
type 3c diabetes mellitus by alleviating hypoglycemic complications associated with total pancreatectomy; (3) and prevent the potential development of pancreatic cancer in this high-risk population. 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 experienced centers using open, laparoscopic, and/or robotic techniques with little morbidity and mortality. From the surgical perspective, the procedure is standardized and can be safely performed in adult and pediatric patients with debilitating chronic pancreatitis. Islet yield and function determine metabolic outcomes.