Successful paratopic pancreas transplantation: a report of three cases with venous portal drainage and enteric exocrine drainage.
Pancreatic transplantation is able to produce euglycemia in patients with Type I diabetes mellitus.  Current surgical techniques utilize revascularization of the graft through the recipient iliac vessels and drainage of the exocrine pancreatic secretions through a duodenal conduit into the bladder.  We describe a technique utilized in 3 patients whereby venous pancreatic drainage is into the portal venous circulation via the proximal splenic vein.  The exocrine pancreatic secretions are drained into the proximal jejunum via a side-to-side donor duodenum to proximal small bowel anastomosis.  Results and complications of this technique are presented.  Potential short-term and long-term advantages and disadvantages of this technique are discussed. Our early experience suggests that paratopic pancreatic transplantation with venous drainage into the portal vein and exocrine drainage into the proximal jejunum is both feasible and desirable.
Department of Surgery, University of Virginia Health Sciences Center Charlottesville.
M B
MB
Ishitani
L K
LK
Rosenlof
J B
JB
Hanks
T L
TL
Pruett
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D005088:Exocrine Glands / Q000378:metabolism*; D005260:Female; D006801:Humans; D007583:Jejunum; D008297:Male; D010179:Pancreas / Q000098:blood supply*; D016035:Pancreas Transplantation / Q000379:methods*; D011169:Portal Vein