title: Pancreaticocystostomy revision for obstructive pancreatitis and pancreatic fistula after segmental pancreatic transplantation.
abstract: Combined kidney-pancreas transplantation is an effective surgical therapy for end-stage renal failure secondary to type I diabetes mellitus. However, obstructive pancreatitis and pancreaticocutaneous fistula remain significant postoperative complications unique to extraperitoneal segmental pancreatic transplantation. We present our experience with 13 patients (7 with obstructive pancreatitis and 6 with pancreaticocutaneous fistulae) after segmental extraperitoneal pancreatic transplantation, who subsequently underwent intraperitoneal reconstruction of the pancreaticocystostomy. This reconstruction was successful in 11 of 13 (85%) patients with minimal morbidity and no mortality. This intraperitoneal approach to reconstruction of the pancreaticocystostomy after segmental extraperitoneal pancreatic transplantation is a safe and effective means of graft salvage and this technique has not been described in the literature.
authors.affiliation: Department of Surgery, University of Texas Health Science Center at San Antonio 78284-7842, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Esterl
authors.forename: N
authors.initials: N
authors.lastname: Gupta
authors.forename: J C
authors.initials: JC
authors.lastname: Reese
authors.forename: B K
authors.initials: BK
authors.lastname: Patel
authors.forename: R B
authors.initials: RB
authors.lastname: Fairchild
authors.forename: H
authors.initials: H
authors.lastname: Solomon
authors.forename: P J
authors.initials: PJ
authors.lastname: Garvin
mesh_terms: D000328:Adult; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D010179:Pancreas / Q000601:surgery*; D016035:Pancreas Transplantation / Q000379:methods*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D010185:Pancreatic Fistula / Q000209:etiology / Q000601:surgery*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D014463:Ultrasonography; D001743:Urinary Bladder / Q000601:surgery*