Douzdjian V, Abecassis M M, Cooper J L, Smith J L, Corry R J
Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City.
Surg Gynecol Obstet. 1993 Nov;177(5):451-6.
Despite recent advances, pancreatic transplantation is still in evolution and is associated with considerable surgical morbidity. We reviewed the surgical complications of 127 consecutive whole pancreatic transplants performed at the University of Iowa between March 1984 and January 1992, to evaluate the impact of these complications on graft and patient outcome. Of these transplantations, 89 were simultaneous pancreatic and renal transplants, 32 pancreas after kidney and six pancreas alone. Of all complications requiring hospital admission, 29 percent were surgical in nature. Graft thrombosis (19 percent), deep wound infection (18 percent), duodenal leak (7 percent) and iliac artery disruption (3 percent) were all associated with significant graft (n = 28) and patient (n = 6) loss. In contrast, recurrent urinary tract infections (20 percent), recurrent pancreatitis (17 percent), superficial wound infections (13 percent) and recurrent hematuria (12 percent) did not affect patient or graft outcome. Surgical complications after technically successful transplants were associated with a 4.9 percent mortality rate and a 4.9 percent graft loss. The overall one year actuarial patient and pancreas graft survival rate was 86 and 75 percent, respectively. Despite ongoing refinements in surgical technique, pancreatic transplantation is still associated with considerable surgical morbidity. However, the outcome is favorable if these complications are managed aggressively.
尽管近年来取得了进展，但胰腺移植仍在不断发展，且伴有相当高的手术并发症发生率。我们回顾了1984年3月至1992年1月在爱荷华大学连续进行的127例全胰腺移植的手术并发症，以评估这些并发症对移植物和患者预后的影响。在这些移植手术中，89例为胰肾联合移植，32例为肾后胰腺移植，6例为单纯胰腺移植。在所有需要住院治疗的并发症中，29%本质上是手术相关的。移植物血栓形成（19%）、深部伤口感染（18%）、十二指肠漏（7%）和髂动脉破裂（3%）均与大量移植物丢失（n = 28）和患者死亡（n = 6）相关。相比之下，复发性尿路感染（20%）、复发性胰腺炎（17%）、浅表伤口感染（13%）和复发性血尿（12%）并不影响患者或移植物的预后。技术上成功的移植术后手术并发症的死亡率为4.9%，移植物丢失率为4.9%。患者和胰腺移植物的总体一年预期生存率分别为86%和75%。尽管手术技术不断改进，但胰腺移植仍伴有相当高的手术并发症发生率。然而，如果积极处理这些并发症，预后是良好的。
