Improved results with a simplified technique for pancreaticoduodenal transplantation with enteric exocrine drainage.

A simplified technique for pancreaticoduodenal transplantation with enteric exocrine drainage is described. The whole-organ pancreaticoduodenal transplant is placed intraperitoneally with vascular anastomosis to the right common iliac artery and the caval vein, respectively. The graft duodenum is anastomosed side-to-side to the most proximal part of the donor jejunum. No Roux-en-Y loop or pancreatic duct catheter is used to protect the anastomosis with this technique. Nevertheless, excellent results have been obtained, with no graft losses occurring due to leakage or infection. With this technique, the 1-yr patient and graft survival rates in uremic recipients of simultaneous renal and pancreas transplants are 100% and 87%, respectively.