title: Exocrine drainage into the duodenum: a novel technique for pancreas transplantation.
abstract: Simultaneous pancreas-kidney transplantation is the treatment of choice for patients suffering from type 1 diabetes mellitus and end-stage renal failure secondary to diabetic nephropathy. Until 1995, about 90% of pancreas transplantations were performed with exocrine drainage into the bladder. Since then the proportion of pancreas transplants with enteric drainage increased steadily because of frequency of complications and long-term disadvantages of bladder drainage. However, the use of enteric drainage removes the opportunity to monitor pancreatic allograft function either by measuring urinary amylase or by carrying out biopsy via cystoscopy. We report a new technique of exocrine pancreatic drainage into the recipient duodenum. This modification places the pancreas graft including the duodenal anastomosis in a retroperitoneal location and, importantly, allows easy graft monitoring via gastroscopy.
authors.affiliation: Klinik und Poliklinik für Allgemeine Chirurgie, Universitätsklinikum Münster, Münster, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Hummel
authors.forename: Martin
authors.initials: M
authors.lastname: Langer
authors.forename: Heiner H
authors.initials: HH
authors.lastname: Wolters
authors.forename: Norbert
authors.initials: N
authors.lastname: Senninger
authors.forename: Jens G
authors.initials: JG
authors.lastname: Brockmann
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D003928:Diabetic Nephropathies / Q000601:surgery; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D016035:Pancreas Transplantation / Q000379:methods*; D046790:Pancreas, Exocrine / Q000378:metabolism