4.5 Article

A single-centre experience of Roux-en-Y enteric drainage for pancreas transplantation

期刊

TRANSPLANT INTERNATIONAL
卷 30, 期 4, 页码 410-419

出版社

WILEY
DOI: 10.1111/tri.12920

关键词

anastomotic haemorrhage; duodenal perforation; enteric drainage; pancreas transplant; Roux-en-Y

资金

  1. NIHR Cambridge Comprehensive Biomedical Research Centre

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Exocrine drainage following pancreas transplantation can be achieved by drainage into the bladder or bowel, the latter typically by direct duodenojejunostomy; the use of Roux-en-Y enteric drainage is uncommon. We report a retrospective analysis of a single-centre experience of Roux-en-Y enteric drainage following pancreas transplantation. Over a 14-year period (2001-2015), 204 consecutive adult pancreas transplants were performed (96.6% simultaneous pancreas and kidney transplants), of which 26.0% were from donors after circulatory death (DCD). During a median followup of 67 months (range 13-183 months), 14 (6.9%) recipients experienced complications related to their enteric drainage. Complications during follow-up included early enteric anastomotic haemorrhage (five patients), non-anastomotic enteric bleeding (one patient), small bowel obstruction (four patients) and graft duodenal perforation (two within 6 weeks, five beyond 12 months). No recipient lost their graft as a direct result of complications related to enteric drainage. Patient and pancreas graft survival at 1 year was 99.0% and 94.0% and at 5 years 91.3% and 84.9%, respectively. We conclude that Roux-en-Y enteric drainage following pancreas transplantation is a safe and effective procedure and facilitates graft salvage in the event of graft duodenal perforation.

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