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125 Cases of duodenoduodenostomy in pancreas transplantation: a single-centre experience of an alternative enteric drainage

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...

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Autores principales: Walter, Martin, Jazra, Martin, Kykalos, Stylianos, Kuehn, Petra, Michalski, Stefan, Klein, Thomas, Wunsch, Andreas, Viebahn, Richard, Schenker, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497354/
https://www.ncbi.nlm.nih.gov/pubmed/24750305
http://dx.doi.org/10.1111/tri.12337
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author Walter, Martin
Jazra, Martin
Kykalos, Stylianos
Kuehn, Petra
Michalski, Stefan
Klein, Thomas
Wunsch, Andreas
Viebahn, Richard
Schenker, Peter
author_facet Walter, Martin
Jazra, Martin
Kykalos, Stylianos
Kuehn, Petra
Michalski, Stefan
Klein, Thomas
Wunsch, Andreas
Viebahn, Richard
Schenker, Peter
author_sort Walter, Martin
collection PubMed
description 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.
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spelling pubmed-44973542015-07-10 125 Cases of duodenoduodenostomy in pancreas transplantation: a single-centre experience of an alternative enteric drainage Walter, Martin Jazra, Martin Kykalos, Stylianos Kuehn, Petra Michalski, Stefan Klein, Thomas Wunsch, Andreas Viebahn, Richard Schenker, Peter Transpl Int Clinical Research 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. John Wiley & Sons, Ltd 2014-08 2014-05-24 /pmc/articles/PMC4497354/ /pubmed/24750305 http://dx.doi.org/10.1111/tri.12337 Text en © 2014 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Clinical Research
Walter, Martin
Jazra, Martin
Kykalos, Stylianos
Kuehn, Petra
Michalski, Stefan
Klein, Thomas
Wunsch, Andreas
Viebahn, Richard
Schenker, Peter
125 Cases of duodenoduodenostomy in pancreas transplantation: a single-centre experience of an alternative enteric drainage
title 125 Cases of duodenoduodenostomy in pancreas transplantation: a single-centre experience of an alternative enteric drainage
title_full 125 Cases of duodenoduodenostomy in pancreas transplantation: a single-centre experience of an alternative enteric drainage
title_fullStr 125 Cases of duodenoduodenostomy in pancreas transplantation: a single-centre experience of an alternative enteric drainage
title_full_unstemmed 125 Cases of duodenoduodenostomy in pancreas transplantation: a single-centre experience of an alternative enteric drainage
title_short 125 Cases of duodenoduodenostomy in pancreas transplantation: a single-centre experience of an alternative enteric drainage
title_sort 125 cases of duodenoduodenostomy in pancreas transplantation: a single-centre experience of an alternative enteric drainage
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497354/
https://www.ncbi.nlm.nih.gov/pubmed/24750305
http://dx.doi.org/10.1111/tri.12337
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