Native Ureterotransplant Ureterostomy for Ureteral Obstruction after Simultaneous Pancreas Kidney Transplantation.
- Author:
Samuel LEE
1
;
Jae Choon LEE
;
Jin Won SEOL
;
Joo Seop KIM
;
Chan Heun PARK
;
Seung Il KIM
;
Sun Hyung JOO
;
Young Cheol LEE
;
Sung Gil PARK
;
Dae Yul YANG
;
Sung Yong KIM
;
Ho Chul KIM
;
Sang Hoon BAE
;
Sook Ja HYUN
;
Chul Jae PARK
;
Dae Won YOON
Author Information
1. Department of Surgery, Hallym University College of Medicine, Seoul, Korea. slee@hallym.or.kr
- Publication Type:Case Report
- Keywords:
Native ureterotransplant ureterostomy;
Pancreas kidney transplantation
- MeSH:
Adult;
Constriction, Pathologic;
Creatinine;
Cystoscopes;
Diabetes Mellitus;
Diabetic Nephropathies;
Drainage;
Follow-Up Studies;
Humans;
Insulin;
Kidney Transplantation*;
Kidney*;
Male;
Pancreas*;
Stents;
Tissue Donors;
Ultrasonography;
Ureter*;
Ureteral Obstruction*;
Ureterostomy*;
Urinary Bladder
- From:Journal of the Korean Surgical Society
2002;63(1):79-83
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Significant surgical complications occur in about half of patients after simultaneous pancreas kidney transplantation (SPK) with bladder drainage. Urologic complications are very common in bladder-drained pancreas transplants. Urinary obstruction occurs in either the early or the late period following transplantation. Predictors of urological complications after transplantation have not been well established. Early obstruction is usually diagnosed by an increment of serum creatinine or through imaging studies, such as ultrasound and antegrade pyelogram. Surgical management is inevitable when conservative managements fails. If the length of the donor ureter is sufficient, it is possible to redo the ureteroneocystostomy. However, if this is not the case or the stricture is at a high level, a native ureterotransplant ureterostomy may be the procedure of choice. SPK was performed on a 36 year old male patient with insulin dependent diabetes mellitus and diabetic nephropathy. The pancreatic exocrine secretion was drained by duodenocystostomy. The patient developed an obstruction in upper ureter on the postoperative 16th day. On the postoperative 32nd day, a native ureterotransplant ureterostomy with a double J stent was performed. The postoperative course was uneventful. The double J stent was removed on postoperative 112nd day by cystoscope. A subsequent follow up showed excellent pancreatic and renal function.
