Gill I S, Sindhi R, Jerius J T, Sudan D, Stratta R J
Department of Surgery, University of Nebraska Medical Center, Omaha, USA.
Clin Transplant. 1997 Apr;11(2):104-9.
Whole organ pancreaticoduodenal transplantation with bladder drainage by the duodenal segment technique is currently the preferred method of vascularized pancreas transplantation but is associated with a finite risk of surgical complications. Meticulous bench reconstruction of the pancreaticoduodenal allograft may minimize complications following transplantation. Over a 6.5-yr period, 192 pancreas transplants were performed in 181 diabetic patients by the same transplant team. A retrospective review was performed in order to describe a stepwise approach to bench preparation of the pancreaticoduodenal allograft that has developed from this experience. In this series of 192 consecutive pancreaticoduodenal reconstructions, no procured pancreas was deemed non-usable solely from an anatomic standpoint. The mean backtable pancreas preparation time was 2 h. The operative complication rate 19%, the incidence of technical graft loss was 6.8%, and there was no mortality related to technical problems.
Using a standardized approach, meticulous bench reconstruction of the pancreaticoduodenal allograft: 1) can be performed in virtually any anatomic setting; 2) decrease complications following transplantation; 3) improves initial allograft function; and 4) minimizes organ wastage.
采用十二指肠段技术行膀胱引流的全器官胰十二指肠移植术目前是血管化胰腺移植的首选方法，但存在一定的手术并发症风险。对胰十二指肠同种异体移植物进行细致的体外重建可减少移植后的并发症。在6.5年的时间里，同一移植团队对181例糖尿病患者进行了192例胰腺移植。进行了一项回顾性研究，以描述基于这一经验发展而来的胰十二指肠同种异体移植物体外准备的逐步方法。在这一系列连续的192例胰十二指肠重建手术中，从解剖学角度来看，没有一个获取的胰腺被认为不可用。体外胰腺准备的平均时间为2小时。手术并发症发生率为19%，技术原因导致移植物丢失的发生率为6.8%，且没有与技术问题相关的死亡病例。
采用标准化方法，对胰十二指肠同种异体移植物进行细致的体外重建：1）几乎可在任何解剖情况下进行；2）减少移植后的并发症；3）改善移植物的初始功能；4）最大限度地减少器官浪费。
