Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1009, USA.
Clin Transplant. 2009 Sep-Oct;23(5):765-8. doi: 10.1111/j.1399-0012.2009.01029.x. Epub 2009 Jun 26.
Unexpected intraoperative findings are not rare in surgical practice. Meckel's diverticulum with a mass is one such example. There are only two previously reported cases of Meckel's in transplantation, and neither involved pancreas transplant.
We present a case report of novel surgical technique using a Meckel's diverticulectomy site for the duodeno-enterostomy to managing the exocrine secretions of the transplanted pancreas. We also discuss management of Meckel's diverticulum. The patient tolerated the procedure without complication, and continues to have normal renal and pancreatic function without any gastrointestinal (GI) complaints. The excised Meckel's diverticulum contained both gastric and pancreatic tissue.
Although uncertainty about the best management practices exists in the general surgery patient population, given the potential complications that may arise from Meckel's diverticulum, in transplant patients the Meckel's should be removed when encountered. The point of excision can safely be incorporated into other intestinal anastomoses.
在外科手术实践中,术中出现意外情况并不罕见。带有肿块的 Meckel 憩室就是一个例子。在移植方面,仅有两例先前报道的 Meckel 憩室病例,且均不涉及胰腺移植。
我们报告了一例使用 Meckel 憩室切除术部位进行十二指肠-空肠吻合术以管理移植胰腺外分泌的新手术技术。我们还讨论了 Meckel 憩室的处理方法。患者在没有并发症的情况下耐受了该手术,并且继续具有正常的肾功能和胰腺功能,没有任何胃肠道(GI)不适。切除的 Meckel 憩室包含胃和胰腺组织。
尽管一般外科患者群体的最佳管理实践存在不确定性,但鉴于 Meckel 憩室可能引起的潜在并发症,在移植患者中遇到 Meckel 憩室时应将其切除。切除部位可以安全地合并到其他肠吻合术中。