Total duodenectomy with enteric duct drainage: a rescue operation for duodenal complications occurring after pancreas transplantation

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
U BoggiP Marchetti

Abstract

Duodenal graft complications (DGC) occur frequently after pancreas transplantation but rarely cause graft loss. Graft pancreatectomy, however, may be required when DGC compromise recipient's safety. We herein report on two patients with otherwise untreatable DGC in whom the entire pancreas was salvaged by means of total duodenectomy with enteric drainage of both pancreatic ducts. The first patient developed recurrent episodes of enteric bleeding, requiring hospitalization and blood transfusions, starting 21 months after transplantation. The disease causing hemorrhage could not be defined, despite extensive investigations, but the donor duodenum was eventually identified as the site of bleeding. The second patient was referred to us with a duodenal stump leak, 5 months after transplantation. Two previous surgeries had failed to seal the leak, despite opening a diverting stoma above the duodenal graft. Thirty-nine and 16 months after total duodenectomy with dual duct drainage, respectively, both patients are insulin-independent and free from abdominal complaints. Magnetic resonance pancreatography shows normal ducts both basal and after intravenous injection of secretin. The two cases presented herein show that when DGC jeopardiz...Continue Reading

References

Jan 1, 1989·Transplantation·A M D'AlessandroF O Belzer
Mar 1, 1993·Transplant International : Official Journal of the European Society for Organ Transplantation·I B Brekke
Jan 1, 1996·American Journal of Surgery·M M MaherJ L Cameron
Dec 3, 1998·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·R J StrattaS J Radio
Dec 9, 1998·Digestive Surgery·G G Tsiotos, M G Sarr
May 2, 2002·Archives of Surgery·Juan M SarmientoMichael B Farnell
Jul 13, 2002·The European Journal of Surgery = Acta Chirurgica·L LundellB Liedman
Jan 28, 2003·Transplantation·Elena OrsenigoValerio Di Carlo
Jan 15, 2005·World Journal of Surgery·Masayuki ImamuraYasuhiro Kawai
Nov 5, 2005·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Richard MackeyCarol Burke
Feb 1, 1922·Annals of Surgery·F C Mann, K Kawamura

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Citations

Nov 26, 2014·Transplantation Proceedings·P D UvaD H Casadei
Dec 6, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Erica PieroniUgo Boggi
Aug 9, 2016·Transplantation Direct·Jerome Martin LaurenceMark S Cattral
Apr 9, 2016·Current Opinion in Organ Transplantation·Jerome M Laurence, Mark S Cattral
Jan 14, 2021·World Journal of Transplantation·Joana Ferrer-Fàbrega, Laureano Fernández-Cruz

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