HPB P01 Evaluating quality of life outcomes following Total Pancreatectomy and Islet Autotransplant for Chronic Pancreatitis

Abstract

Abstract Background Chronic Pancreatitis (CP) is a debilitating condition that is associated with significant patient morbidity. The disease is characterised by chronic abdominal pain that is recurring and relapsing, which subsequently has a significant impact on the patients’ quality of life. In addition to the stigma associated with the disease, patients often undergo social isolation and are unable to maintain functional status. Total Pancreatectomy and Islet Auto transplant for Chronic Pancreatitis (TPIAT) serves as opportunity to alleviate the pain whilst preserving endocrine function. Our aim was to evaluate whether TPIAT also improved patients quality of life. Methods A retrospective review of all patients referred to the TPIAT service in Oxford between 2019 -2022 was performed. Clinical information was recorded regarding patient demographics, aetiology and previous treatment of CP, intraoperative data (islet yield secured) and post operative complication rate. Long term endocrine function, analgesic use and quality of life was formally assessed. Results Of the 39 patients referred to the service, 23 (59%) were listed for TPIAT. TPIAT was successfully performed in 21 patients. The median age of this cohort was 22. Hereditary pancreatitis was the most frequent aetiology in 48%. The median length of stay post procedure was 12.5 days. During the last follow up, freestyle libre interrogation highlighted that 79% of patients had blood sugars within the target range. A significant reduction in analgesia use was noted (p=0.001), in addition to a marked reduction in opiate based analgesics (p=0.001). Resolution of pancreatic pain was also significantly apparent in the cohort (p=0.001). Conclusions TPIAT for CP serves as an effective treatment strategy as it provides symptomatic relief for patients, reduces long term narcotic use, permits glycaemic control and improves quality of life for patients.