Duodenoduodenostomy in pancreas transplantation

Gunasekaran G, Wee A, Rabets J, Winans C, Krishnamurthi V. Duodenoduodenostomy in pancreas transplantation. :  Enteric drainage (ED) using duodenojejunostomy (DJ) is an established technique in pancreatic transplantation. Duodenoduodenostomy (DD), an alternative ED technique, may provide unique adva...

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Bibliographic Details
Published in:Clinical transplantation 2012-07, Vol.26 (4), p.550-557
Main Authors: Gunasekaran, Ganesh, Wee, Alvin, Rabets, John, Winans, Charles, Krishnamurthi, Venkatesh
Format: Article
Language:English
Subjects:
Adult
Anastomosis, Surgical
Biological and medical sciences
Drainage
Duodenostomy - mortality
duodenum
Duodenum - surgery
enteric drainage
Female
Follow-Up Studies
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Graft Survival
Humans
Jejunum
Male
Medical sciences
Middle Aged
pancreas transplantation
Pancreas Transplantation - mortality
Postoperative Complications
Prognosis
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
surgical complications
Survival Rate
Tissue, organ and graft immunology
Transplantation, Homologous
Young Adult
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Summary:Gunasekaran G, Wee A, Rabets J, Winans C, Krishnamurthi V. Duodenoduodenostomy in pancreas transplantation. :  Enteric drainage (ED) using duodenojejunostomy (DJ) is an established technique in pancreatic transplantation. Duodenoduodenostomy (DD), an alternative ED technique, may provide unique advantages over DJ. We compared our experience with these two types of ED through a retrospective review of all pancreas transplants performed at our institution from November 2007 to November 2009. The allograft duodenum was anastomosed to the recipient jejunum or duodenum. Duodenal drainage was performed by a stapled or hand‐sewn technique. Patient demographics, operative times, major post‐operative complications, and graft survival data were analyzed. Of 57 pancreas transplants, DJ was performed in 36 patients, stapled DD in 14 patients, and hand‐sewn DD in seven patients. Two DD grafts (9.5%) thrombosed compared with no DJ grafts (p = NS). Enteric leak and small‐bowel obstruction occurred in 3 of 36 DJ patients and in two DD patients (p = NS). Gastrointestinal bleeding occurred more frequently in stapled DD compared with DJ (4 vs. 0, p 
ISSN:0902-0063
1399-0012
DOI:10.1111/j.1399-0012.2011.01563.x