Exocrine drainage into the duodenum: a novel technique for pancreas transplantation

SummarySimultaneous pancreas–kidney transplantation is the treatment of choice forpatients suffering from type 1 diabetes mellitus and end-stage renal failuresecondary to diabetic nephropathy. Until 1995, about 90% of pancreas trans-plantations were performed with exocrine drainage into the bladder. Sincethen the proportion of pancreas transplants with enteric drainage increasedsteadily because of frequency of complications and long-term disadvantagesof bladder drainage. However, the use of enteric drainage removes theopportunity to monitor pancreatic allograft function either by measuring uri-nary amylase or by carrying out biopsy via cystoscopy. We report a newtechnique of exocrine pancreatic drainage into the recipient duodenum. Thismodification places the pancreas graft including the duodenal anastomosis ina retroperitoneal location and, importantly, allows easy graft monitoring viagastroscopy. Transplant International ISSN 0934-0874 a 2007 The Authors 178 Journal compilation a 2007 European Society for Organ Transplantation 21 (2008) 178–181