Drainage of the exocrine pancreas in clinical transplantation: comparison of bladder versus enteric drainage in a consecutive series.
The purpose of this study was to define the incidence of urologic and metabolic complications after simultaneous kidney/pancreas transplantation (SKPT) with bladder drainage (BD). Review of 55 SKPT with BD performed between 1989 and 1995 demonstrated patient, kidney, and pancreas survival rates of 95%, 89%, and 78%, respectively, with a mean follow-up of 41 months (range 12-78 months). Over this follow-up period 78% of these patients experienced a urinary tract infection, 27% had hematuria, and 38% had at least one hospital admission for dehydration. Recent experience with primary enteric drainage of the exocrine secretions of the transplanted pancreas (n = 11) has demonstrated the total absence of these complications (follow-up range 2-12 months). These results suggest the value of continuous re-evaluation of surgical techniques as the care of transplant patients evolve.
Pearson
T C
TC
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Santamaria
P J
PJ
Routenberg
K L
KL
O'Brien
D P
DP
Whelchel
J D
JD
Neylan
J F
JF
Larsen
C P
CP
D000138:Acidosis / Q000209:etiology; D000328:Adult; D000714:Anastomosis, Surgical; D003681:Dehydration / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D014525:Urethral Stricture / Q000209:etiology; D014526:Urethritis / Q000209:etiology; D001743:Urinary Bladder / Q000601:surgery*; D014552:Urinary Tract Infections / Q000209:etiology; D014570:Urologic Diseases / Q000209:etiology