Duct-enterostomy as a treatment of pancreatic fistula in a bladder-drained pancreas transplant.

A case of combined pancreaticoduodeno-renal transplant with good graft function was complicated by recurrent episodes of graft pancreatitis treated by vesical catheter drainage. Four months after transplantation, a fistula from the pancreatic body associated with ascitis was identified. Anastomosis between pancreatic fistula and an individualized jejunal loop was performed. The duodenocystostomy was not disconnected. A splint placed inside the wirsung was exteriorized percutaneously through the jejunal loop and removed 30 days after the operation. Both kidney and pancreas grafts are functioning normally 2 years after transplantation.