Impact of Age on Outcomes of Total Pancreatectomy: A Narrative Review.

Total pancreatectomy (TP) is a complex and rarely performed procedure. With advances in surgical techniques, perioperative care, and islet auto transplantation, TP has seen renewed clinical interest. This narrative review explores the current evidence on outcomes following TP, with a focus on age-related differences in morbidity, mortality, metabolic challenges, quality of life, and survival. Relevant literature from peer-reviewed journals was reviewed to compare perioperative and long-term outcomes in younger versus older patients undergoing TP, including the role of total pancreatectomy with islet auto transplantation (TPIAT). Although TP is associated with significant metabolic and nutritional challenges, advances in perioperative management have improved outcomes. Older patients often experience longer hospital stays and reduced long-term survival compared to younger cohorts, though age alone is not a contraindication. Islet yields in children tend to be higher, while readmission rates and postoperative recovery patterns vary between age groups. Age influences several outcome parameters following TP but should not be considered an absolute barrier to surgery. Careful patient selection, individualized metabolic support, and multidisciplinary management are critical for optimizing outcomes across all age groups.