Re Jan's questions about Total Pancreatectomy

[Guest guest]

> Hi, I'm new to this group. My husband gets pancreatits about twice

a

> year for the past three years, and he is in the hospital as of

now .

> This seams to be the worst one yet.I read that you had your

pancreas

> removed? Can a person survive without it? My husband is also a

> diabetic. What is a whipple?--

Hi Jan,

I'm assuming you will probably get lots of responses to this

question, but the short answer is a resounding " yes " , one can live

without a pancreas. As has been mentioned, there are a number of

folks on this message board who have undergone that procedure, and

are quite willing to share their experiences with others.

There are 2 main functions for the pancreas - exocrine, meaning the

production of digestive enzymes, and endocrine, meaning the

regulation of blood sugar levels through the production of insulin

and glucagon. Both these functions can be replaced by medications

(enzymes such as creon or viokase, and insulin via shots or, in some

cases, pills).

Dr. Sutherland, a surgeon from the University of Minnesota, is

considered to be one of the pioneers in the field of pancreas

surgeries, including total pancreatectomy, auto and allo islet cell

transplants, and whole pancreas transplants. He was one of the guest

speakers at this year's 4th Annual Symposium on Pancreatitis,

sponsored by PAI (this organization). He did 3 sessions, and talked

about the various surgical options his team has to offer patients who

suffer from chronic pancratitis. " Auto islet cell " means they

harvest the islet cells from the patient's own pancreas after the

pancreas is removed and inject them into the liver, where they

continue to function, with the hope of preventing the patient from

becoming diabetic. Since you said your husband is already a

diabetic, that auto islet cell transplant is proably not an option.

" Allo islet cell " means injecting the islet cells from a donor

(either cadaver or living) into the patient's liver. The difference

here is that, like other organ transplants, the patient would need to

take some sort of anti-rejection drugs for the rest of his/her life.

If an " allo islet cell " , or even full pancreas transplant is done,

Dr. Sutherland usually recommends doing that as a separate procedure,

AFTER recovery from the initial pancreatectomy surgery has

completed. Some of his patients decide that they can deal with being

diabetic, and can control/manage it well enough with taking insulin.

Others decide to subsequently have either the allo islet cell

transplant (much less invasive procedure - the islet cells are

injected by needle directly into the liver); or full pancreas

transplant (Dr. Sutherland says the time on the waiting list for a

pancreas transplant right now is fairly low - about 6 months,

usually, mostly because the demand is not that high for a " pancreas-

only " transplant). One other " snag " with the allo islet cell

transplant at the present time is that it is still considered to

be " experimental " by the insurance companies (even though it has been

going on since 1977), and it is difficult to get them to pay for it.

Many folks have been successful in getting insurance to pay for AUTO

islet cell TRANSFER procedure, since it is not really considered to

be a TRANSPLANT.

You can view download/view the handouts from Dr. Sutherland's

presentations (along with those of the other speakers) by going to:

http://pancassociation.org/symposium_2003_handouts.html

We also have an 8-hour video tape of most of the presentations from

this year's symposium available (including all of Dr. SUtherland's

sessions, and another session which was a " panel discussion " by 4 of

his patients who have underdone the TP/ICT procedure). If you would

like to order a copy of the video, send a check or money order for

$15 to:

Karyn /PAI

6936 West 71st Street

Indianapolis, IN 46278

Cheers,

--Tull

Assistant Moderator

Pancreatitis Association, Int'l