Pancreatic transplantation for diabetes mellitus. Discussion of indications and surgical technique with reference to 3 cases.
Three patients reveived segmental pancreatic transplants. In two the main indication was hyperlabile diabetes, and in the third progressive loss of vision. Vascular anastomoses were to the iliac vessels, the graft being placed extraperitoneally. The pancreatic duct was ligated in the first case, while the other two, the transected end of the pancreatic graft was implanted into a jejunal Roux-Y loop. Two of the patients had normal blood glucose levels without insulin administration for 40 and 35 days, respectively. The grafts then underwent rejection and were removed. In both cases the postoperative course was complicated by pancreatic fistulae. In the 3rd patient the graft failed on the day after operation, due to venous trombosis.
D000328:Adult; D003920:Diabetes Mellitus / Q000601:surgery*; D006084:Graft Rejection; D006801:Humans; D008026:Ligation; D008297:Male; D016035:Pancreas Transplantation; D010183:Pancreatic Ducts / Q000601:surgery; D014184:Transplantation, Homologous