Duodenal patch and sphincterotomy: modification of an old technique to prevent graft pancreatitis

Transplantation Proceedings
T GrochowieckiA Swiech-Zarzycka

Abstract

The aim of this study was to preliminarily evaluate the duodenal patch technique combined with open sphincterotomy in terms of prevention of graft pancreatitis. From April 2003 to March 2005, 17 simultaneous pancreas and kidney transplantations were performed using this technique. All recipients are alive with good renal transplant function. Directly after sphincterotomy in 16 pancreatic grafts a good outflow of clear pancreatic juice and a lessening of graft tenseness were observed during surgery. In two transplants an additional sphincterotomy of the Santorini duct sphincter was necessary. In one recipient no pancreatic juice secretion was observed and insulin independence was not obtained. This graft was explanted shortly afterward. In 13 recipients no graft pancreatic or peripancreatic fluid collection requiring intervention was observed. Of the three recipients who developed graft pancreatitis, two required graft pancreatectomy. In conclusion, Sphincterotomy facilitates pancreatic juice outflow by reducing intraoperative graft edema, which could lead to subsequent inflammation. Further studies on the factors inducing graft pancreatitis are necessary to eliminate this severe complication.

References

Jan 1, 1989·Transplantation·A M D'AlessandroF O Belzer
Jun 16, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Oliver DrognitzStefan Benz

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Citations

May 18, 2011·Journal of Intensive Care Medicine·Joseph R Scalea, Matthew Cooper
Dec 21, 2012·Current Opinion in Organ Transplantation·Silvio NadalinAlfred Königsrainer
Feb 7, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·Franka MessnerChristian Margreiter

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