Total pancreatectomy with islet autotransplant (TPIAT): Relief is possible from chronic pancreatitis

The TPIAT procedure includes removal of the inflamed pancreas and reconstruction of the digestive tract. Because you still need insulin-producing islet cells to control your blood sugar, we save your islet cells from the diseased pancreas. During the operation, the surgeon will re-implant your islet cells into your liver. Over time, the islet cells should adjust to their new home and start producing insulin again. At first, you will need to give yourself insulin injections but the goal for each patient is to reduce or eliminate the need for these injections. Most patients experience considerable improvement with their pain following this procedure.

Once you are referred to our team, we will schedule an evaluation to determine whether you are a good candidate for TPIAT. Your evaluation begins with a day of blood tests and imaging scans. You also will meet with our team, which includes doctors who specialize in:

• Gastroenterology

• Endocrinology

• Pain management

• Pancreas surgery

• Islet production

• Genetics

The team also includes:

• Advanced practice providers

• Certified transplant nurse coordinators

• Nurses

• Social workers

• Genetic counselors

• Diabetes educators

The surgeon begins by removing the pancreas, which is sent to the islet laboratory. There, the insulin-producing islet cells are extracted from the pancreas and purified so they can be re-implanted into the liver later during the operation. The appendix, gallbladder and spleen are also removed to prevent complications after surgery.

Hospital stay

Most patients are hospitalized for 10 to 14 days after surgery. During this time, we will teach you about temporary insulin management, self-care and follow-up appointments. If you live more than four hours from Madison, we’ll ask you to stay in the area for one to two weeks until we know it’s safe for you to go home.

Follow-up care

You will require follow-up care for six months after surgery. We typically see patients in the clinic at three weeks and six weeks post-surgery. At these visits, we gauge how well your islet cells are working and watch for signs of infection. We order lab tests and schedule appointments to monitor your health so you can live an active and healthy life.

Most patients report significant pain relief and improvement in their quality of life. Patients will give themselves insulin injections and monitor their blood sugar in the short-term. The goal is to wean off insulin after several months. Patients also are required to take pills to replace the digestive enzymes that had been produced by the pancreas.