Impact of Decompression Tube Placement in Duodenal Graft on Graft Perforation After Pancreas Transplantation

Background. Duodenal graft perforation (DGP) is a serious complication after pancreas trans-plantation (PTx) and can lead to pancreas graft loss. Here, we investigated whether the placement of a decompression tube (DT) for the duodenal graft during PTx is clinically useful for prevent-ing DGP.Methods. This study included 54 patients who received PTx for type 1 diabetes at our institu-tion between 2000 and 2020. Among these cases, 28 included DT placement (51.9%; DT group), and the remaining 26 without DT placement (non-DT group) were used as historical controls for comparison to the cases with DT placement.Results. Among all 54 cases, DGP occurred in 7 (13.0%). The DGP incidence did not signifi- cantly differ between the DT group (10.7%, 3/28 cases) and the non-DT group (15.4%, 4/26 cases) (P = .6994). Logistic regression analysis showed that DT placement did not affect DGP risk. Nota-bly, 5 cases in the DT group (17.9%) exhibited adverse effects that were likely the result of DT placement, including bleeding from tube contact (2 cases), enterocutaneous fistula at the DT place-ment site (2 cases), and intraabdominal abscess around the DT site (1 case). Pancreas graft survival after PTx did not significantly differ between the DT and non-DT groups (P = .6260).Conclusions. The DT group did not exhibit superior outcomes compared with the non-DT group. This result suggests that DT placement did not have a clinical impact on DGP prevention after PTx.

Automated summary

This study investigated the clinical usefulness of placing a decompression tube (DT) for prevention of duodenal graft perforation (DGP) during pancreas transplantation (PTx). The results showed that there was no significant difference in DGP incidence between the DT group and the non-DT group. However, adverse effects related to DT placement were observed in some cases. Therefore, the placement of DT may not have a clinical impact on DGP prevention after PTx.