[Pancreas transplantation with bladder and intestinal drainage technique with systemic-venous and initial experiences with portal venous drainage. Which technique can be recommended today?].
The experience worldwide with pancreas transplantation includes more than 9000 cases. In the most popular patient group (simultaneous pancreas-kidney transplantation, SPK) the graft-function rate at 1 year now reaches more than 80%. More than 90% of all pancreas transplants were performed using the bladder-drainage technique (BD) with systemic venous anastomosis. Late problems with the BD require enteric conversion in 10-20% in the long term. In the present study we report the results of 40 SPK using the BD (n = 20) and enteric drainage (ED) techniques (n = 20). After 3 months, the patients pancreas and kidney survival rates in the BD group were 100, 95 and 100% and in the ED group 100, 100 and 100%, respectively. No anastomosis leakage occurred in either group. In two cases of the ED group the pancreas grafts were drained portal venously via the superior mesenteric vein without surgical complications. With growing experience, excellent SPK results can be reached with both the BD and ED techniques.
Büsing
M
M
Martin
D
D
Schulz
T
T
Heimes
M
M
Klempnauer
J
J
Kozuschek
W
W
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery; D014680:Veins / Q000601:surgery
Pankreastransplantation in der Blasen- und Darmdrainagetechnik mit systemischvenöser und ersten Erfahrungen mit der portalvenösen Ableitung. Welche Technik kann heute empfohlen werden?