High duodeno-jejunal anastomosis as a safe method of enteric drainage in simultaneous pancreas and kidney transplantation.
One of the key issues in successful pancreas transplantation is uncomplicated drainage of pancreas exocrine secretion.


OBJECTIVE
The aim of the study is to present results of side-to-side high duodeno-jejunal anastomosis as routine method of enteric drainage in simultaneous pancreas kidney transplantation (SPK).


METHODS
30 diabetic patients underwent SPK at the Department of Surgery, Ruhr University Bochum in 2001. The pancreas was drained using a portion of duodenal segment anastomosed to the first loop of jejunum about 20-40 cm distal to the Treitz ligament.


RESULTS
Early relaparotomy was required in 20% patients. The mean time of first relaparotomy was 5.5 (range 1-11) days after transplantation. In 10% of cases graft pancreatectomy was necessary. Perioperative mortality was 3.3%. Currently 83.3% patients are insulin-free and 86.6% patients are free of dialysis.


CONCLUSIONS
These data suggest, that side-to-side high duodeno-jejunal anastomosis is a safe method of drainage of pancreas exocrine secretion in SPK.
Ziaja
Jacek
J
Department of Surgery, Ruhr-University Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Germany. ziacek@mp.pl
Wullstein
Christoph
C
Woeste
Guido
G
Bechstein
Wolf Otto
WO
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D003928:Diabetic Nephropathies / Q000601:surgery; D004322:Drainage / Q000379:methods; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods* / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome