Total Pancreatectomy with Islet Autotransplantation

For patients suffering from chronic pancreatitis, a total pancreatectomy with islet autotransplantation (TPIAT) procedure can be effective in reducing pain, improving the quality of life and maintaining stable glucose control.

Our Capabilities

Since 1999, UC Health has been one of the only major centers in the U.S. to offer pancreatectomy (removal of the pancreas) with autologous islet cell transplantation to treat chronic pancreatitis.

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With careful research, we create a personalized plan for you that takes into account everything from your age to your medication tolerance. Side by side, our team of subspecialists diagnose, treat and manage your pancreatic cancer to provide the best care possible for you in a caring and comfortable environment.

To schedule an appointment, please call the UC Health Pancreatic Disease team at 513-584-8900.

Help Along the Way

Answers to Your Total Pancreatectomy with Islet Autotransplantation (TPIAT) Questions

TPIAT is a procedure that involves removing the patient's pancreas, removing the islet cells (cells in the pancreas that produce insulin) from the pancreas and then implanting the islet cells back into the patient's liver. Once the cells have been infused into the liver, they may begin to take over the function of the pancreas and produce insulin.

This procedure is primarily for patients with severe chronic pancreatitis who haven’t had success with less invasive forms of treatment. TPIAT allows a patient to be treated for the pain of pancreatitis without the repercussions of developing diabetes.

To begin the process, you will meet with one of our subspecialists to review your medical history and records. Our multidisciplinary board members will review your body scans to determine if you are a candidate for this procedure. If approved, we will then contact your insurance carrier to verify benefits and coverage.

Patients express a dramatic improvement in their quality of life after a total pancreatectomy with islet autotransplantation, and most patients that previously were on narcotics to control abdominal pain can wean off of all pain medications. In addition, our most recent analysis demonstrates that approximately 30% of patients do not require any insulin after surgery, and the remaining patients maintain stable glucose control.

As with any surgery, there are some risks and potential complications. Your surgeon will assess and review your specific risks in detail as you prepare for surgery. Risks depend on each patient’s medical and surgical history and current health status and may vary greatly from person to person. Potential complications include:

  • Postoperative fluid collections or abscess formation – leaking can occur at the procedure sites and can cause fluid to accumulate within the abdomen. This fluid can sometimes become infected, causing an abscess. Often, these leaks resolve on their own without any intervention. Occasionally, they may need to be drained by placing a tube into the abdominal wall or in the abscess. The tube is removed once the drainage resolves. On rare occasions, another surgery may be required to resolve the problem.
  • Delayed gastric emptying – in some instances, the stomach seems to “fall asleep” following surgery. The result is difficulty eating, feeling full quickly, nausea and sometimes vomiting. This will eventually improve on its own, but there is no way to determine how long it may take. Some patients may need to have a temporary feeding tube if they are not able to eat enough on their own.
  • Wound infection or breakdown – abdominal incisions can occasionally become infected, or there may be areas that do not completely close by the time the staples are removed. Initially, the incision may appear completely closed and later start seeping drainage, or a small bulge may develop near the incision. This may mean there is a small collection of fluid under the skin. This is easily fixed by gently opening these areas with a cotton swab and then performing packing twice daily until the incision heals from the bottom up. Antibiotics are prescribed if the incision becomes infected. Healing may take several weeks.
  • Blood clots/pneumonia – blood clots can occur in either the legs or lungs. Patients are given blood thinners at the time of surgery and compression boots/special stockings are applied after surgery to reduce this risk. Patients are also ordered to be out of bed and walking very soon after surgery to prevent blood clots and other respiratory problems such as pneumonia.

Bleeding or cardiac arrest – Significant bleeding or cardiac arrest are rare complications that may occur after TPIAT.

Here’s what else you can expect with this procedure:

  • Estimated length of surgery: 6–10 hours.
  • Estimated time in surgical intensive care unit: 48–72 hours.
  • Estimated hospital stay: 7–10 days.
  • Estimated post-operative recovery: 6–8 weeks

Preparing for Surgery and Return Home

To help prepare you for what to expect before, during and after your procedure, please see below.

Insurance Approval

Our billing office will seek insurance approval for this procedure. Precertification is completed as needed, according to your insurance requirements and plan coverage.

Disability/Family and Medical Leave Act (FMLA) Paperwork

We are happy to complete any necessary paperwork for you or your family to allow for time off work, so please provide it as soon as possible. Forms are usually completed within 7–10 business days.

Preoperative Work-Up

Preoperative tests may include a CT scan, blood tests within one month of surgery, a chest X-ray, an anesthesiologist evaluation, a physical exam and/or cardiac or pulmonary evaluation.

What to Bring

Please bring the following with you: Patient information packet, comb/brush, toothbrush, toothpaste, eyeglasses and case, robe and slippers, cane, walker, CPAP, crutches, photo ID, insurance card, living will/power of attorney and medication list.

When Can I Go Home?

You must be able to eat and drink, control your pain with oral medication and show that your bowels function normally before being discharged from the hospital.

When You Return Home

During your recovery, try to walk a bit every day, continue your breathing/coughing exercises, avoid strenuous activity until approved by your surgeon and do not drive while taking pain medication.

Insurance Approval

Our billing office will seek insurance approval for this procedure. Precertification is completed as needed, according to your insurance requirements and plan coverage.

Disability/Family and Medical Leave Act (FMLA) Paperwork

We are happy to complete any necessary paperwork for you or your family to allow for time off work, so please provide it as soon as possible. Forms are usually completed within 7–10 business days.

Preoperative Work-Up

Preoperative tests may include a CT scan, blood tests within one month of surgery, a chest X-ray, an anesthesiologist evaluation, a physical exam and/or cardiac or pulmonary evaluation.

What to Bring

Please bring the following with you: Patient information packet, comb/brush, toothbrush, toothpaste, eyeglasses and case, robe and slippers, cane, walker, CPAP, crutches, photo ID, insurance card, living will/power of attorney and medication list.

When Can I Go Home?

You must be able to eat and drink, control your pain with oral medication and show that your bowels function normally before being discharged from the hospital.

When You Return Home

During your recovery, try to walk a bit every day, continue your breathing/coughing exercises, avoid strenuous activity until approved by your surgeon and do not drive while taking pain medication.

When to Call Your Surgeon

Call your surgeon if you experience severe or increased pain, a fever of 101.0 or higher, persistent nausea or vomiting, difficult bowel movements, a rash or itching, shortness of breath or chest pain, drainage, leg pain or swelling and/or redness, pus or bleeding.

Partner with Us

Referring Physicians: Success and Provider Toolbox

We are committed to providing optimal care to your patient and open communication with you. As a referring physician, we understand that you need to be kept informed on your patient’s progress. That’s why we set up a toolbox to share detailed information about your patient’s health with you.

For referral information, call:

Pancreatic Disease News

Specialized UC Surgery Cures Cleveland Teen of Chronic Pancreatitis

For teenagers, junk food is typically a way of life. However, Westlake, Ohio, resident Courtney D. Avino, 18, wasn’t able to enjoy all of the bad foods that taste so good or really any food without experiencing intense pain until just a few years ago.
chronic pancreatitis cure

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