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Total pancreatectomy with islet autotransplantation as an alternative to high-risk pancreatojejunostomy after pancreaticoduodenectomy. A prospective randomized trial.

Balzano G, Zerbi A, Aleotti F, Capretti G, Melzi R, Pecorelli N et al.

Ann Surg 2023; 277: 894-903.

Total pancreatectomy (TP) was associated with reduced perioperative morbidity: 60 versus 90.3%, P=0.008, and similar hospital stay, in this study that included 61 procedures. Survival rates were also similar, but TP was associated with a higher risk of diabetes.

Comment: Intriguing, and could lead to a change in standard care.

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