Modified simultaneous kidney-pancreatico-duodenal transplantation with enteric drainage of exocrine pancreatic secretions: a case report
- VernacularTitle:改良的胰液空肠引流式胰腺、十二指肠肾脏一期联合移植1例报告
- Author:
Yeyong QIAN
;
Bingyi SHI
;
Ming CAI
- Publication Type:Journal Article
- Keywords:
insulin-dependent diabetes mellitus;
transplantation;
pancreas;
kidney
- From:
Medical Journal of Chinese People's Liberation Army
1983;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the technique of modified simultaneous renal-pancreatico-duodenal transplantation (SKPT) with enteric drinage (ED). Methods Simultaneous pancreaticoduodenal and kidney transplantation of cadaver donors has been performed for one uremic patient with insulin-dependent diabetes mellitus (IDDM). The allograft exocrine secretions were drained into the proximal jejunum via a side-to-side duodenojejunostomy (non Roux-en-Y). The patient received an immunosuppression therapy including zenapax (CD25 antibody), FK506, mycophenolate mofitil (MMF), and predinisone. Results Exogenous insulin was withdrawn on the 7 th day after operation and the renal function became normal on the 3 rd day. No serious surgical complication occurred. 35 days after operation, the patient was discharged with normal pancreatic and renal function. Conclusions (1) The modified ED-SKPT without Roux-en-Y anastomosis is a safe and effective procedure for the treatment uremia accompanied by of IDDM. (2) The modified ED-SKPT (non Roux-en-Y) is simpler than traditional method (with Roux-en-Y) in surgical technique, and it has no operation related complications as seen after BD-SKPT (simultaneous kidney-pancreatico-duodenal transplantation with bladder drainage). (3) Current immunosuppressive agents and good HLA-typing may decrease complications.
