Published online Jun 24, 2016. doi: 10.5500/wjt.v6.i2.437
Peer-review started: February 14, 2016
First decision: March 1, 2016
Revised: April 4, 2016
Accepted: April 21, 2016
Article in press: April 22, 2016
Published online: June 24, 2016
Total pancreatectomy and islet auto transplantation is a good option for chronic pancreatitis patients who suffer from significant pain, poor quality of life, and the potential of type 3C diabetes and pancreatic cancer. Portal vein thrombosis is the most feared complication of the surgery and chances are increased if the patient has a hypercoagulable disorder. We present a challenging case of islet auto transplantation from our institution. A 29-year-old woman with plasminogen activator inhibitor-4G/4G variant and a clinical history of venous thrombosis was successfully managed with a precise peri- and post-operative anticoagulation protocol. In this paper we discuss the anti-coagulation protocol for safely and successfully caring out islet transplantation and associated risks and benefits.
Core tip: Total pancreatectomy and islet auto-transplantation is an option for select patients with chronic pancreatitis. Portal vein thrombosis is the most feared surgical complication and chances are increased if the patient has a hypercoagulable disorder. The paper describes important topics like the management of the anticoagulation in the peri-operative period.