Open Access125 Cases of duodenoduodenostomy in pancreas transplantation: a single‐centre experience of an alternative enteric drainage
Author(s) -
Walter Martin,
Jazra Martin,
Kykalos Stylianos,
Kuehn Petra,
Michalski Stefan,
Klein Thomas,
Wunsch Andreas,
Viebahn Richard,
Schenker Peter
Publication year - 2014
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12337
Subject(s) - medicine , anastomosis , surgery , pancreas transplantation , transplantation , biopsy , thrombosis , gastroenterology , kidney transplantation
Summary Several exocrine drainage procedures have been successfully developed to perform pancreas transplantation ( PT ). Retroperitoneal graft placement allows exocrine drainage via direct duodenoduodenostomy ( DD ). This technique provides easy access for endoscopic surveillance and biopsy. A total of 241 PT procedures were performed in our centre between 2002 and 2012. DD was performed in 125 patients, and duodenojejunostomy ( DJ ) in 116 patients. We retrospectively compared our experience with these two types of enteric drainage, focusing on graft and patient survivals, as well as postoperative complications. With a mean follow‐up of 59 months, both groups demonstrated comparable patient and graft survivals. 14 (11%) of 125 cases in the DD group and 21 (18%) of 116 cases in the DJ group had pancreatic graft loss ( P = 0.142). Graft thrombosis [5 (4%) vs. 18 (16%) P = 0.002], anastomotic insufficiency [2 (1.6%) vs. 8 (7%) P = 0.052] and relaparotomy [52 (41%) vs. 56 (48%) P = 0.29] occurred more frequently in the DJ group, whereas gastrointestinal bleeding [14 (11%) vs. 4 (3%) P = 0.026] occurred more often in the DD group. DD is a feasible and safe technique in PT , with no increase in enteric complications. It is equivalent to other established techniques and extends the feasibility of anastomotic sites, especially in recipients who have undergone a second transplantation.