INTRODUCTION: Total pancreatectomy and autologous transplantation of pancreatic islets is a method for the management of patients with painful or severe chronic pancreatitis. In the standard procedure, pancreatic islets are isolated and subsequently administered into the portal vein. Possible complications of this procedure may include portal vein thrombosis or portal hypertension. In case of patients with a history of thrombosis or patients at risk of thrombosis (history of hepatotropic virus infections), this administration route may be risky.  Preclinical studies conducted by our department led to the development of a novel method of transplantation of endoscopic islets transplantation into gastric submucosa. In 2013, the first and another in 2014 endoscopic islets autotransplantation have been performed.  

AIMS: The aim of this study is to present the results of a three-years follow-up of autologus gastric submocosa transplantation.

MATERIALS AND METHODS: In years 2013-2014, 2 pancreatectomy procedures were performed by Child's method along with subsequent autologous transplantation pancreatic islets underneath the gastric mucosa of the stomach. Both patients completed the three-year follow-up period.

RESULTS: The procedure was performed in 2 male patients aged 46 a years, suffering from chronic pancreatitis requiring chronic analgesic treatment. Both patients had been previously diagnosed with diabetes; one was subjected to dietary management while other received insulin treatment. In both cases, own islet activity was detected, with fasting peptide C levels of 0.81 and 0.6 ng/mL, respectively; the values doubled after glucose challenge. Hepatotropic virus infections were detected in both cases; in addition, right portal vein thrombosis was diagnosed in one patient. Peptide C concentration after pancreatectomy and before pancreatic cell transplant was 0.1 ng/mL. After the transplant, respectively peptide C concentrations in both patients were 0.8 and 0.5 ng/mL on post-transplant day 7; 1.2 and 0.6 ng/mL on day 90; 1.3 and 0.8 ng/mL on day 180; 1.1 and 0.7 ng/mL on day 360 and 3 and 0.6 ng/ml respectively three years post transplantation. The pain symptoms resolved in both cases.

CONCLUSIONS: Pancreatic islets may survive under the mucosal membrane of the stomach; endoscopic gastric submucosa transplantation may present an alternative management of patients who cannot undergo classic transplant procedure.