Islet Cell / TPIAT
Also covered as: acute recurrent pancreatitis · chronic pancreatitis · pancreas divisum · acute pancreatitis · exocrine insufficiency · portal vein thrombosis · central sensitization · delayed gastric emptying
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Answers come only from this collection's statement ledger and cite the exact moment · not medical advice
Content of this collection
Foundations
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Welcome and Introductions: Pancreatic Disease
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Dr. Todd Ponsky introduces the event onacute pancreatitis, recurrent and chronic pancreatitis, exocrine insufficiency, interventional procedures as well as surgical indications for the diseased pancreas in children, culminating with a state
video · 6:04 · Jan 2019
Surgical Management
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Total Pancreatectomy with Islet Autotransplantation: Pancreatic Disease
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Dr. Jaimie Nathan introduces the session, covering indications for total pancreatectomy with islet auto-transplantation(TPIAT), pre-TPIAT evaluation, pre- and post-operative management, and long-term follow-up.Dr. Joe Palermopresents a chro
video · 47:20 · Jan 2019
Total pancreatectomy with islet autotransplantation (TPIAT) - Cincinnati Children's Pancreas Care Center
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In this video, we take you through a Total Pancreatectomy with Islet Autotransplantation (TPIAT)—one of the most complex abdominal surgeries performed in children. Learn about who qualifies for TPIAT, the surgical process, and the critical
video · 10:19 · Dec 2024
Complications
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Pancreatitis in pediatric patients with pancreatic solid pseudopapillary neoplasms- a single center experience
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Stephen J Hartman, Nicolas Noriega, Raphael M Parrado, Emily Vore, Andrew Trout, David Vitale, Maisam Abu-El-Haija, Juan P GurriaBackground: Though rare, solid pseudopapillary neoplasms (SPN) are one of the most common, low-grade, malignant
video · 0:59 · Apr 2026
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Every statement below comes from the recorded discussions, with its speaker and moment.
Pancreatitis in pediatric patients with pancreatic solid pseudopapillary neoplasms- a single center experience
Solid pseudopapillary neoplasms are one of the most frequent pancreatic tumors in pediatric patients
epidemiologicalLizzie Lee0:09 ↗
Surgery for solid pseudopapillary neoplasms is usually curative and outcomes are excellent
clinicalLizzie Lee0:15 ↗
In a single center study, 10 adolescent girls underwent surgical resection for solid pseudopapillary neoplasms
clinicalLizzie Lee0:22 ↗
3 out of 10 patients developed acute recurrent or chronic pancreatitis after resection
clinicalLizzie Lee0:25 ↗
Every patient who developed ongoing pancreatitis had genetic risk factors like CFTR gene variants or pancreas divisum
clinicalLizzie Lee0:32 ↗
Some patients with post-resection pancreatitis ultimately required completion pancreatectomy
clinicalLizzie Lee0:40 ↗
Identifying genetic and anatomic risk factors before surgery may change management of patients with solid pseudopapillary neoplasms
opinionLizzie Lee0:48 ↗
Total pancreatectomy with islet autotransplantation (TPIAT) - Cincinnati Children's Pancreas Care Center
TPIAT is one of the most complex abdominal surgical procedures performed in children
clinicalJuan Gurria0:48 ↗
Surgical indications for TPIAT are for patients with either chronic or acute recurrent pancreatitis
clinicalJuan Gurria0:54 ↗
Patients are candidates for TPIAT when all medical and endoscopic therapy has failed
guidelineJuan Gurria1:02 ↗
TPIAT patients usually have a genetic mutation that drives the disease
clinical1:08 ↗
TPIAT patients typically present with chronic debilitating pain that can lead to opioid addiction or severe impairment of their mental health
clinical1:08 ↗
Full evaluation by the Pancreas Care Center team includes GI, social worker, endocrine, surgery, radiology, genetics, behavioral health, physical therapy, anesthesia and pain team
clinicalJuan Gurria1:23 ↗
Patients are prepared with vaccinations for potential splenectomy before surgery
clinicalJuan Gurria1:49 ↗
Pain catheters are placed in the transversus abdominis muscle by pain specialists
clinicalJuan Gurria2:40 ↗
Central venous catheter placement uses ultrasound for vein puncture and fluoroscopy for appropriate insertion
clinical2:46 ↗
The pancreas has often been injured for years, which makes the dissection procedure quite challenging
clinicalJuan Gurria3:14 ↗
Blood supply to the pancreas is preserved until the very last moment because hypoxia of islet cells cannot be risked
clinicalJuan Gurria4:06 ↗
Digestive enzymes including collagenases and neutral proteases are injected into pancreatic ducts to break down extracellular matrix
clinicalRita Bottino4:51 ↗
Enzyme injection turns the solid pancreas organ into liquid form by releasing islet cells and exocrine cells
clinical5:24 ↗
Islet number correlates with good outcome
clinicalRita Bottino5:45 ↗
Maximum infusion volume is 5 mL per bag with 3 bags maximum per patient
clinical5:59 ↗
Islet cells are suspended in medium with albumin, heparin, and antibiotics
clinicalRita Bottino6:14 ↗
Islet cells are infused into the portal vein with the goal of implanting in the liver and producing insulin
clinicalJuan Gurria7:15 ↗
Portal vein pressures are constantly checked during islet infusion to prevent portal vein thrombosis
clinicalJuan Gurria7:25 ↗
Portal vein thrombosis could cause significant morbidity to the patient
clinicalJuan Gurria7:25 ↗
Patients are placed in intensive care unit to control hemodynamics and fluid shift balance
clinicalJuan Gurria8:01 ↗
Islet cells need to heal in a homeostatic environment
clinicalJuan Gurria8:12 ↗
Glucose and insulin are controlled via exogenous infusions post-operatively
clinicalJuan Gurria8:18 ↗
Nutrition is key in the healing of connections between the biliary tract and gastrointestinal tract
clinicalJuan Gurria8:22 ↗