title: Bench reconstruction of pancreas for transplantation: experience with 192 cases.
abstract: Whole organ pancreaticoduodenal transplantation with bladder drainage by the duodenal segment technique is currently the preferred method of vascularized pancreas transplantation but is associated with a finite risk of surgical complications. Meticulous bench reconstruction of the pancreaticoduodenal allograft may minimize complications following transplantation. Over a 6.5-yr period, 192 pancreas transplants were performed in 181 diabetic patients by the same transplant team. A retrospective review was performed in order to describe a stepwise approach to bench preparation of the pancreaticoduodenal allograft that has developed from this experience. In this series of 192 consecutive pancreaticoduodenal reconstructions, no procured pancreas was deemed non-usable solely from an anatomic standpoint. The mean backtable pancreas preparation time was 2 h. The operative complication rate 19%, the incidence of technical graft loss was 6.8%, and there was no mortality related to technical problems.
  
  
  CONCLUSIONS
  Using a standardized approach, meticulous bench reconstruction of the pancreaticoduodenal allograft: 1) can be performed in virtually any anatomic setting; 2) decrease complications following transplantation; 3) improves initial allograft function; and 4) minimizes organ wastage.
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, USA.
authors.forename: I S
authors.initials: IS
authors.lastname: Gill
authors.forename: R
authors.initials: R
authors.lastname: Sindhi
authors.forename: J T
authors.initials: JT
authors.lastname: Jerius
authors.forename: D
authors.initials: D
authors.lastname: Sudan
authors.forename: R J
authors.initials: RJ
authors.lastname: Stratta
mesh_terms: D003920:Diabetes Mellitus / Q000601:surgery; D004386:Duodenum / Q000637:transplantation; D006801:Humans; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies