Back to Annual Meeting Posters

Introduction: The incidence of weight loss following total pancreatectomy with islet autotransplantation for chronic pancreatitis and its effect on insulin requirements and Quality of life (QOL) post-operatively is poorly understood.
Method: A prospectively collected, IRB approved database at a single institution was reviewed. Patients with a BMI greater than or equal to 25 were compared to those with a BMI less than 25 prior to surgery. Data pertaining islet yield, insulin requirements, laboratory results, and quality of life (QOL) were reviewed at 6 months and 1 year following surgery. The SF12 survey was used to asses QOL (normal population 50, SD 10). QOL is improved if the result increases by at least 3 points or is > or = to 35.
Results: 100 consecutive patients were reviewed (78 females, average age 42) from March 2009 to present. 19 patients were omitted due to lack of at least 6 month post-op data and 12 patients were omitted who were insulin diabetics pre-op. 42/69 patients (60%) were overweight or obese prior to surgery (BMI > 25), with an average BMI pre-op of 30, prealbumin 23, A1C 5.5, pQOL 25, mhQOL 36, and took no insulin prior to surgery. Their median islet yield was 244,781 IEQ and 3,316 IEQ/kG (range 14,312-1,168,725 IEQ, 234-16,009 IEQ/Kg). At 1 year post-op, their BMI decreased to 25, and prealbumin was 17, A1C 7.6, pQOL 34, mhQOL 41, mean daily insulin 21 u. 34/42 (80%) of these overweight patients had a sustained post-operative weight loss of at least 10% of their pre-op weight. Comparatively, the patients who had a BMI < 25 prior to surgery (n=27) were found to have an average BMI 20 pre-op, prealbumin 21, A1C 5.6, pQOL 26, mhQOL 36, and took no insulin prior to surgery. Their median islet yield was 150,168 IEQ and 2,370 IEQ/Kg (range 16,266 - 816,425 IEQ, 312 - 15404 IEQ/Kg). At 1 year post-op, their BMI was 19, Pre-albumin 15, A1C 7.1, pQOL 35, mhQOL 41, and they averaged 10 u/D insulin. The difference in insulin requirements between the two groups is statistically significant (p=0.042).
Conclusion: Patients who are overweight or obese prior to TPIAT require more insulin following surgery even though they have higher islet yield and experience significant weight loss compared to those who are not overweight prior to surgery. Both groups experienced an improved physical and mental health QOL following TPIAT.