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Rare surgery performed to remove pancreas, prevent diabetes

In a 12-hour, dual-stage surgery known to be performed at only two other centers in the U.S., doctors at the University of Alabama at Birmingham on Tuesday returned a patient's own insulin-producing cells to him after surgically removing his pancreas to eliminate constant, severe pain from chronic pancreatitis.

The patient, Leonard Stewart, 47, of Panama City, Fla., remained anesthetized in the operating room at UAB Hospital through removal of his entire pancreas and the hours-long wait for the pancreatic islet cells to be processed in a specialized UAB laboratory. The cells were then returned to the operating room and infused into the patient's liver, where they have begun to produce insulin.

Few hospitals have the technologically sophisticated facilities necessary to isolate and purify the pancreatic islet cells either from a cadaver donor for transplantation or, as in this case, for infusion back into the same patient.

The removal of the entire pancreas is an accepted, although radical last-resort, surgery to give relief from pain, usually from inflammation of pancreatitis. In the past, such surgery might eliminate the pain but would leave the patient with severe, poorly-controlled diabetes, since the insulin-producing islets of Langerhans would necessarily be discarded along with the rest of the organ. Patients without functioning islet cells have to take insulin for life. Retrieving and relocating the natural insulin-producing cells from the pancreas saves patients from the complications of severe, poorly-controlled diabetes. Loss of the other major function of the pancreas, production of digestive enzymes, is dealt with by taking the enzymes as a dietary supplement.

Leading the complex operation were Drs. Selwyn M. Vickers, Devin E. Eckhoff and Juan L. Contreras. Vickers, who removed the pancreas, directs a clinic for the management of chronic pancreatitis, is chief of gastrointestinal surgery and co-director of the UAB Pancreati
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Source:University of Alabama at Birmingham


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