Is TPIAT Right for My Child?
Patients who are considered initial candidates for TPIAT have been experiencing abdominal pain for more than six months and have a significantly reduced quality of life. They are often unable to attend school or be active, and may have been hospitalized numerous times for pain. TPIAT may also be beneficial in children with genetic risk factors for pancreatitis.
TPIAT is not right for every child with acute recurrent or chronic pancreatitis, however. Your child’s pancreas anatomy and vasculature will be thoroughly examined to make sure TPIAT is the best surgical option. Our expert team will consider your child’s age and whether he or she has had any other surgical procedures, together with their other health and risk factors.
Before undergoing TPIAT at Nationwide Children’s, your child will receive a full medical and surgical evaluation.
The TPIAT Evaluation Process
Our multidisciplinary Pancreas Care team will be involved in evaluating your child’s medical history and eligibility for TPIAT. Your child will have appointments with our pediatric pancreas surgeons, gastroenterologists specializing in pancreas care, endocrinologists, pain management specialists, infectious disease experts, psychologists, dietitians, social workers and nurses. Genetic counselors and other services may also be used, based on a child’s individual needs. We will work together to determine if TPIAT is right for your child.
Your child may need to undergo testing during the evaluation. These tests may include:
- Blood tests, to check the function and health of your child’s pancreas, liver, and kidneys, vitamin levels, iron levels and more
- Imaging tests, such as computed tomography (CT) or magnetic resonance imaging (MRI) with or without cholangiopancreatography (MRCP), or ultrasound to evaluate the anatomy
- Endoscopic ultrasound (EUS) or endoscopic retrograde cholangiopancreatography (ERCP), to examine your child’s pancreatic and ductal anatomy. ERCP may be used for diagnosis purposes – to examine the anatomy – or as an intervention to correct narrow biliary or pancreatic ducts
- Nutrition and enzyme evaluations, such as the mixed meal test, to check the response of the pancreas to food
- Genetic testing, to check for genetic risk factors for pancreatitis
Our Pancreas Care team will work to get a thorough picture of your child’s health and pancreas problems. They will make sure your family understands your child’s condition and treatment options. During your evaluation, the team will teach you about TPIAT and what the procedure and recovery will be like.
After our team has your child’s test results, they will meet to discuss the best care plan for your child. They will consider:
- The cause of your child’s condition
- The presence of any genetic risk factors for pancreatitis
- The severity of your child’s pain and disease
- Your family’s ability to manage the hospital stay and recovery process
- The full range of treatment options available to your child
- Your child’s chances for a positive treatment outcome for all available options
- How likely TPIAT is to offer your child the best possible outcome
In some cases, your child may require further testing before our team can make a decision. We will evaluate the new information as soon as it is available and talk with your family about the final decision.
In other cases, your child may benefit from other treatment options before TPIAT should be considered, or TPIAT may not be the right fit. If your child is not a candidate for TPIAT, our multidisciplinary clinical and surgical pancreas team will offer the best solution for your child’s specific needs.
If your child is a candidate for TPIAT, we will work with your family to schedule the operation and make arrangements for the hospital stay.
