Cure ofpancreaticoduodenal anastomotic leakage after simultaneous pancreas-kidney transplantation with enteric drainage:a case report and literature review
10.3760/cma.j.issn.0254-1785.2019.05.006
- VernacularTitle:肠引流式同期胰肾联合移植后胰十二指肠吻合口瘘治愈的一例并文献复习
- Author:
Desheng LI
1
;
Shanbin ZHANG
;
Fanjun ZENG
;
Yi WANG
;
Jinzhu XIAO
;
Jian XU
;
Houqin LIU
;
Liang XU
;
Peng CAO
;
Huajun ZHANG
Author Information
1. 海南医学院第二附属医院
- Keywords:
Simultaneous pancreas and kidney transplantation;
Pancreas graft;
Duodenum graft;
Anastomotic leakage
- From:
Chinese Journal of Organ Transplantation
2019;40(5):280-283
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience of one case of anastomotic leakage after simultaneous pancreas-kidney transplantation (SPK ) with enteric drainage .Methods One case of type 2 diabetes mellitus complicated with end-stage nephropathy undergoing SPK was retrospectively analyzed .Iliac venous systemic circulation was employed for pancreatic venous reflux ,transplanted pancreas exocrine via enteric drainage and side-to-side anastomosis between donor pancreaticoduodenum and recipient jejunum . Pancreatoduodenal anastomotic leakage occurred at 12 days post-operation .During re-operation ,Roux-en-Y anastomosis was established between donor pancreaticoduodenum and recipient jejunum .And the relevant domestic and foreign literatures were searched .Results The follow-up time was 3 month after a second operation .Recipient pancreas and kidney transplantation survived well . There was no onset of enteric leakage .The incidence of anastomotic leakage varies greatly between different transplantation centers both at home and abroad .The incidence ranged from 3 .6％ to 11 .3％ .And the risk of pancreatic loss was as high as 54 .6％ .Conclusions As a severe postoperative complication ,anastomotic fistula after SPK may cuase abdominal infection . Even after reparing enteric fistula , the risk of leakage remains high . Roux-en-Y anastomosis is other therapeutic option .
