50 consecutive pancreas transplants with enteric drainage and extraperitoneal placement of the pancreatic graft

摘要

BACKGROUND: The surgical technique and tactics of pancreas transplantation are issues not fully resolved as yet. The beginnings of pancreas transplant program at our center date 20 years back, the history of the program being characterized by seeking and looking for the best surgical techniques. METHODS: In line with global trends, we have employed the enteric drainage technique with the last fifty pancreas transplants. The pancreatic graft was placed outside the peritoneal cavity. RESULTS: One-year actual patient and pancreas survival rates in this set of transplants were 96 percent and 88 percent, respectively. Apart from the healing of the wound, surgical complications were seldom encountered. The most frequent complication in our group of patients was bleeding. CONCLUSIONS: The current standard is to transplant whole pancreas with the duodenal segment and enteric drainage. The extraperitoneal placement of the pancreatic graft facilitates access during mandatory biopsies of the graft, which is an essential advantage especially for isolated pancreas transplants.