Pancreas Surgery, Return of Islet Cells

During dual-stage surgery known to have been performed at only two other U.S. centers, doctors returned a patient's own insulin-producing cells to him after surgically removing the pancreas to eliminate constant and severe pain from chronic pancreatitis.

The patient remained anesthetized in the operating room at the University of Alabama (UAB, Birmingham, USA) through the removal of his pancreas and the hours-long wait for the pancreatic islet cells to be processed in a specialized laboratory. The islet cells were then infused into the patient's liver, where they have begun to produce insulin. Few hospitals today have the technologically sophisticated facilities necessary to isolate and purify the pancreatic islet cells.

In the past, pancreatic surgery might have alleviated the pain but would have left the patient with severe, poorly controlled diabetes, since the insulin-producing islets of Langerhans would necessarily be discarded along with the rest of the organ. The new procedure was first performed at the University of Minnesota and the patient still survives. Only a few other cases were attempted, and the results were not uniformly good, so the procedure fell out of favor until recently, when new advances in cadavaric islet cell transplantation made outcomes more favorable.

The current operation was performed by Dr. Selwyn M. Vickers, chief of gastrointestinal surgery at the UAB Pancreaticobiliary Center. The patient's chronic pancreatitis developed four years ago as the result of a congenitally malformed pancreatic duct that closed down following removal of his gallbladder earlier. Three prior operations and several procedures to place stents in the pancreatic duct failed to provide relief. Facing a life of suffering from constant pain, the patient chose the alternative of total removal of the pancreas and the autologous islet cell transplantation.




Related Links:
U. of Alabama