Retroperitoneal pancreas transplantation with a Roux-en-Y duodenojejunostomy for exocrine drainage.

IF 1.6 3区 医学 Q2 SURGERY BMC Surgery Pub Date : 2024-11-13 DOI:10.1186/s12893-024-02658-y
Mogeli Sh Khubutiya, Ilya V Dmitriev, Nikita S Zhuravel, Aslan G Balkarov, Roman V Storozhev, Yuri A Anisimov, Alexander S Kondrashkin, Nonna V Shmarina
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Abstract

Background: Pancreatic transplantation is the only definitive surgical treatment for diabetes mellitus. Currently, most transplant centers use enteric exocrine drainage of pancreatic secretions; however, experts disagree on which part of the gastrointestinal tract is preferable for enteric anastomosis. We analyzed the outcomes of retroperitoneal pancreatic transplantation with enteric drainage of pancreatic secretions.

Materials and methods: We evaluated the outcomes of 60 simultaneous retroperitoneal pancreas-kidney transplantations. Based on the type of enteric anastomosis, the patients were divided into two groups: the study group consisted of 10 patients who underwent enteric drainage via Roux-en-Y duodenojejunostomy, and the control group included 50 patients who underwent exocrine drainage via duodenoduodenal anastomosis. No statistically significant differences were observed between the groups in terms of the main parameters.

Results: The rate of surgical complications did not differ significantly between the groups (p > 0.05). Clavien IVb complications occurred only in the control group (n = 4.8%). The in-hospital pancreatic graft survival rate in both groups was 80%, whereas the recipient survival rates were 90% and 84%, in the study and control groups, respectively (p < 0.05).

Conclusion: Retroperitoneal pancreatic transplantation with exocrine drainage via a Roux-en-Y duodenojejunostomy is an effective alternative technique that reduces the rate of severe surgical complications.

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采用 Roux-en-Y 十二指肠空肠吻合术进行腹膜后胰腺移植以排出外分泌。
背景:胰腺移植是治疗糖尿病的唯一确切手术方法。目前,大多数移植中心使用肠道外分泌引流胰腺分泌物;然而,专家们对肠道吻合术最好在胃肠道的哪个部位进行意见不一。我们分析了采用肠道引流胰腺分泌物的腹膜后胰腺移植的结果:我们评估了 60 例同时进行的腹膜后胰腺-肾脏移植手术的结果。根据肠吻合类型,患者被分为两组:研究组包括 10 名通过 Roux-en-Y 十二指肠空肠吻合术进行肠引流的患者,对照组包括 50 名通过十二指肠吻合术进行外分泌引流的患者。两组患者的主要参数在统计学上无明显差异:结果:各组手术并发症发生率无明显差异(P>0.05)。只有对照组出现了 Clavien IVb 并发症(n = 4.8%)。两组的院内胰腺移植物存活率均为 80%,而研究组和对照组的受体存活率分别为 90% 和 84%(P 结论:研究组和对照组的胰腺移植物存活率均为 80%,而研究组和对照组的受体存活率分别为 90% 和 84%:通过 Roux-en-Y 十二指肠空肠吻合术进行外分泌引流的腹膜后胰腺移植是一种有效的替代技术,可降低严重手术并发症的发生率。
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来源期刊
BMC Surgery
BMC Surgery SURGERY-
CiteScore
2.90
自引率
5.30%
发文量
391
审稿时长
58 days
期刊介绍: BMC Surgery is an open access, peer-reviewed journal that considers articles on surgical research, training, and practice.
期刊最新文献
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