Duodenal complications in bladder-drained pancreas transplantation

Nadey S. Hakim, Angelika C Gruessner, Basil E. Papalois, Christoph Troppmann, David L. Dunn, David E R Sutherland, Rainer W G Gruessner

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background. The most common type of pancreas transplantation is whole pancreaticoduodenal (with bladder drainage) from a cadaver donor. Complications can arise not only from the pancreas itself but also from the simultaneously transplanted duodenum. The purpose of this study was to analyze the incidence, diagnosis, and treatment of duodenal complications and their impact on patient and pancreas graft survival rates. Methods. Our retrospective study is based on 425 pancreaticoduodenal transplantations performed between July 1, 1986, and June 30, 1994. Complications pertaining to the duodenal segment were labeled early if they occurred within the first postoperative month and late otherwise. Mean follow-up was 55 months (range, 13 to 108 months). Results. We noted 85 (20%) duodenal complications: duodenal leaks (n = 42), hematuria (n = 26), recurrent urinary tract infections (n = 9), duodenal ulceration or necrosis (n = 6), and bladder stones (n = 2). Of these complications, 40 (48%) required surgical intervention. In all, duodenal complications resulted in 14 (16%) enteric conversions and eight (9%) pancreas graft losses (six because of duodenal leak and 2 because of hematuria). The mortality rate from duodenal complications was 0%. Conclusions. Duodenal complications were common, but they were not associated with a high rate of pancreas graft loss (only 9%). With early diagnosis and treatment, morbidity can be reduced and death avoided in pancreas transplant recipients.

Original languageEnglish (US)
Pages (from-to)618-624
Number of pages7
JournalSurgery
Volume121
Issue number6
DOIs
StatePublished - Jun 1997
Externally publishedYes

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Pancreas Transplantation
Pancreas
Urinary Bladder
Hematuria
Urinary Bladder Calculi
Transplants
Graft Survival
Duodenum
Cadaver
Urinary Tract Infections
Early Diagnosis
Drainage
Necrosis
Survival Rate
Retrospective Studies
Transplantation
Tissue Donors
Morbidity
Mortality
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Hakim, N. S., Gruessner, A. C., Papalois, B. E., Troppmann, C., Dunn, D. L., Sutherland, D. E. R., & Gruessner, R. W. G. (1997). Duodenal complications in bladder-drained pancreas transplantation. Surgery, 121(6), 618-624. https://doi.org/10.1016/S0039-6060(97)90049-0

Duodenal complications in bladder-drained pancreas transplantation. / Hakim, Nadey S.; Gruessner, Angelika C; Papalois, Basil E.; Troppmann, Christoph; Dunn, David L.; Sutherland, David E R; Gruessner, Rainer W G.

In: Surgery, Vol. 121, No. 6, 06.1997, p. 618-624.

Research output: Contribution to journalArticle

Hakim, NS, Gruessner, AC, Papalois, BE, Troppmann, C, Dunn, DL, Sutherland, DER & Gruessner, RWG 1997, 'Duodenal complications in bladder-drained pancreas transplantation', Surgery, vol. 121, no. 6, pp. 618-624. https://doi.org/10.1016/S0039-6060(97)90049-0
Hakim NS, Gruessner AC, Papalois BE, Troppmann C, Dunn DL, Sutherland DER et al. Duodenal complications in bladder-drained pancreas transplantation. Surgery. 1997 Jun;121(6):618-624. https://doi.org/10.1016/S0039-6060(97)90049-0
Hakim, Nadey S. ; Gruessner, Angelika C ; Papalois, Basil E. ; Troppmann, Christoph ; Dunn, David L. ; Sutherland, David E R ; Gruessner, Rainer W G. / Duodenal complications in bladder-drained pancreas transplantation. In: Surgery. 1997 ; Vol. 121, No. 6. pp. 618-624.
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abstract = "Background. The most common type of pancreas transplantation is whole pancreaticoduodenal (with bladder drainage) from a cadaver donor. Complications can arise not only from the pancreas itself but also from the simultaneously transplanted duodenum. The purpose of this study was to analyze the incidence, diagnosis, and treatment of duodenal complications and their impact on patient and pancreas graft survival rates. Methods. Our retrospective study is based on 425 pancreaticoduodenal transplantations performed between July 1, 1986, and June 30, 1994. Complications pertaining to the duodenal segment were labeled early if they occurred within the first postoperative month and late otherwise. Mean follow-up was 55 months (range, 13 to 108 months). Results. We noted 85 (20{\%}) duodenal complications: duodenal leaks (n = 42), hematuria (n = 26), recurrent urinary tract infections (n = 9), duodenal ulceration or necrosis (n = 6), and bladder stones (n = 2). Of these complications, 40 (48{\%}) required surgical intervention. In all, duodenal complications resulted in 14 (16{\%}) enteric conversions and eight (9{\%}) pancreas graft losses (six because of duodenal leak and 2 because of hematuria). The mortality rate from duodenal complications was 0{\%}. Conclusions. Duodenal complications were common, but they were not associated with a high rate of pancreas graft loss (only 9{\%}). With early diagnosis and treatment, morbidity can be reduced and death avoided in pancreas transplant recipients.",
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AU - Sutherland, David E R

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N2 - Background. The most common type of pancreas transplantation is whole pancreaticoduodenal (with bladder drainage) from a cadaver donor. Complications can arise not only from the pancreas itself but also from the simultaneously transplanted duodenum. The purpose of this study was to analyze the incidence, diagnosis, and treatment of duodenal complications and their impact on patient and pancreas graft survival rates. Methods. Our retrospective study is based on 425 pancreaticoduodenal transplantations performed between July 1, 1986, and June 30, 1994. Complications pertaining to the duodenal segment were labeled early if they occurred within the first postoperative month and late otherwise. Mean follow-up was 55 months (range, 13 to 108 months). Results. We noted 85 (20%) duodenal complications: duodenal leaks (n = 42), hematuria (n = 26), recurrent urinary tract infections (n = 9), duodenal ulceration or necrosis (n = 6), and bladder stones (n = 2). Of these complications, 40 (48%) required surgical intervention. In all, duodenal complications resulted in 14 (16%) enteric conversions and eight (9%) pancreas graft losses (six because of duodenal leak and 2 because of hematuria). The mortality rate from duodenal complications was 0%. Conclusions. Duodenal complications were common, but they were not associated with a high rate of pancreas graft loss (only 9%). With early diagnosis and treatment, morbidity can be reduced and death avoided in pancreas transplant recipients.

AB - Background. The most common type of pancreas transplantation is whole pancreaticoduodenal (with bladder drainage) from a cadaver donor. Complications can arise not only from the pancreas itself but also from the simultaneously transplanted duodenum. The purpose of this study was to analyze the incidence, diagnosis, and treatment of duodenal complications and their impact on patient and pancreas graft survival rates. Methods. Our retrospective study is based on 425 pancreaticoduodenal transplantations performed between July 1, 1986, and June 30, 1994. Complications pertaining to the duodenal segment were labeled early if they occurred within the first postoperative month and late otherwise. Mean follow-up was 55 months (range, 13 to 108 months). Results. We noted 85 (20%) duodenal complications: duodenal leaks (n = 42), hematuria (n = 26), recurrent urinary tract infections (n = 9), duodenal ulceration or necrosis (n = 6), and bladder stones (n = 2). Of these complications, 40 (48%) required surgical intervention. In all, duodenal complications resulted in 14 (16%) enteric conversions and eight (9%) pancreas graft losses (six because of duodenal leak and 2 because of hematuria). The mortality rate from duodenal complications was 0%. Conclusions. Duodenal complications were common, but they were not associated with a high rate of pancreas graft loss (only 9%). With early diagnosis and treatment, morbidity can be reduced and death avoided in pancreas transplant recipients.

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