Laparoscopic biopsy after pancreaticoduodenal transplantation. A first report.

Over the past 5 years, graft biopsy has become the gold standard for diagnosing rejection or graft dysfunction after pancreas transplantation. Until now, only three types of pancreas graft biopsies have been described: percutaneous, transcystoscopic, and open laparotomy. Percutaneous biopsy (whether computerized tomography scan or ultrasound guided) is unsuccessful 20% of the time. In recipients of enterically drained pancreas grafts, a transcystoscopic biopsy cannot be done. The only other alternative has been an open laparotomy. We report one case of laparoscopic biopsy of an enterically drained pancreas graft, after a percutaneous biopsy was unsuccessful. We conclude that laparoscopic pancreas graft biopsy is a safe and effective method for diagnosing graft dysfunction. It also avoids the complications and prolonged hospitalization of an open laparotomy. Laparoscopic biopsy should become another valuable tool for diagnosing pancreas graft dysfunction.