Tydén G, Tibell A, Groth C G
Department of Transplantation Surgery, Karolinska Institute, Huddinge Hospital, Stockholm, Sweden.
Clin Transplant. 1991 Feb;5(1):36-9.
When a pancreatic transplant program was initiated in Stockholm in 1974 we elected to use enteric drainage of the pancreatic juice; 103 segmental pancreatic transplantations were performed with this technique. However, in 1988 we began to use pancreatico-duodenal grafts with enteric exocrine drainage and we have now performed 25 such procedures. Here we report the technical aspects of this procedure. The cumbersome pancreatico-enteric anastomosis previously needed for enteric drainage has now been replaced by a simple bowel-to-bowel anastomosis. In the present series, only one graft was lost due to the enteric drainage technique, i.e. because of exocrine leakage. No grafts were lost in thrombosis. In the uremic recipients of combined renal and pancreatic grafts the 1-year actuarial graft survival rate was 86%. Pancreatico-duodenal transplantation with enteric exocrine drainage would, therefore, seem to be a sound surgical procedure which is also physiological and not associated with any long-term sequelae.
1974年斯德哥尔摩启动胰腺移植项目时，我们选择采用胰液肠内引流术；用该技术进行了103例节段性胰腺移植。然而，1988年我们开始使用具有肠外分泌引流的胰十二指肠移植物，目前已进行了25例此类手术。在此我们报告该手术的技术要点。先前肠内引流所需的繁琐胰肠吻合术现已被简单的肠肠吻合术所取代。在本系列中，仅1例移植物因肠内引流技术丢失，即由于外分泌漏。无移植物因血栓形成而丢失。在肾和胰腺联合移植的尿毒症受者中，1年移植物预期存活率为86%。因此，具有肠外分泌引流的胰十二指肠移植似乎是一种合理的外科手术，具有生理性且无任何长期后遗症。
