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Vol 4, No 2 (2002)
Published online: 2002-09-03

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Methods of pancreatic exocrine drainage in simultaneous pancreas and kidney transplantation

Jacek Ziaja, Lech Cierpka, Robert Król
Chirurgia Polska 2002;4(2):81-88.

Abstract

Simultaneous pancreas and kidney transplantation (SPK) is considered to be the best method of treatment for patients with type 1 diabetes mellitus that progressed to end stage renal failure.
The aim of the study is to present the most common methods of pancreatic exocrine secretion drainage in pancreas transplantation as well as compare their efficacy and the complications occurring after them. At the moment the most common are bladder (BD) and enteric (ED) drainage. In BD the duodenum is anastomosed to the urinary bladder dome. BD is related to a number of complications, like urinary tract infections, haematuria and leak at the site of anastomosis, which in large percentage require enteric conversion. In ED graft duodenum can be anastomosed to ileal or jejunal loop or to the limb of Roux Y loop. One-year patient and graft survival after SPK do not differ in both methods of drainage. Performed ED reduces the number of infections after transplantation, the rate of urological complications, the incidence of pancreatic juice leak and the number of required re-operations.
At the moment ED is the best way of pancreatic juice drainage in SPK. Although the results of pancreas transplantation as regards patient and pancreas graft survival are comparable for both methods, much fewer complications are observed in the case of ED.

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