1136-P: Chemical Pancreatectomy as a Revolutionary Therapy for Chronic Pancreatitis and Prevention of Type 3C Diabetes

Abstract

Background: Chronic pancreatitis (CP) is a debilitating disease that leads to chronic pain, pancreatic endocrine and exocrine dysfunction. CP affects > 140,000 in the U.S. and millions worldwide. Type 3C diabetes, a brittle form of diabetes, constitutes 9% of those hospitalized with diabetes. Total pancreatectomy with auto islet cell transplantation (TPIAT) may treat CP and preserve endocrine function, but it is major surgery, the outcomes are variable, and islet yield is questionable. Methods: An intrapancreatic infusion of 150 µL of acetic acid or sham was performed on 8-week old CD1 mice. Serum enzymes, GTT, GSIS, behavioral pain assessment, histology and IHC were done 4 weeks and 8 weeks after surgery. Results: There was no significant difference between the two groups in serum amylase and lipase, GTT, GSIS, and pain parameters. IHC revealed negative staining for amylase and normal insulin staining while histology showed intact islets, replacement of acinar cells with fat cells, and no signs of inflammation. Conclusion: This procedure may be a revolutionary non-invasive therapy for CP able to relieve pain and preserve endocrine function. It may rescue ailing islets by removing the source of injury (exocrine tissue) without major surgery. The loss of the exocrine tissue is trivial because it is not functional, and most patients with CP require enzyme replacement therapy. Disclosure M. Saleh: None. R.S. Kalsi: None. G. Gittes: None.