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Transplant Proc. 2009 Jul-Aug;41(6):2469-71. doi: 10.1016/j.transproceed.2009.06.077.

Conversion from bladder to enteric drainage for complications after pancreas transplantation.

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  • 1Servicio di Cirugía General, Hospital Doce de Octubre, Madrid, Spain. carlos.jimenez@inforboe.es

Abstract

OBJECTIVE:

Bladder drainage (BD) of exocrine secretions is associated with urological and pancreatitis complications. Herein we have analyzed our experience with conversion from BD to enteric drainage (ED).

PATIENTS AND METHODS:

From March 1995 to September 2008, 118 patients underwent pancreas transplantation. There were 68 men and 50 women of a overall mean age at transplantation of 37.8 years. There were 66 patients with bladder drainage (BD) and 52 with enteric drainage (ED).

RESULTS:

Eight of 66 BD pancreas recipients (12.1%) underwent ED conversion. The mean time from pancreas transplantation to ED conversion was 29.3 +/- 30.6 months (range, 1-91 months). The major indications for conversion were recurrent reflux pancreatitis and chronic urinary tract infections in 7 patients; metabolic acidosis in 8; urethritis with severe perineoscrotal swelling in 1; and duodenocystostomy leak in 1. A comparative analysis of converted ED and not converted BD showed only a significantly prolonged period in the intensive care unit for patients who needed ED conversion (89 vs 47 hours; P < .01). Only 1 patient showed a duodenoenteric leak and peritonitis after conversion that required removal of the pancreas graft. The remaining 7 patients did not develop any postoperative complications and are currently well, showing normal pancreas graft function at a mean follow-up of 51.7 months after ED conversion. Patient and graft survivals were 100% and 87.5%, respectively. After ED conversion all urological complications disappeared; patients discontinued the use of oral bicarbonate.

CONCLUSION:

ED conversion in pancreas transplant recipients with urological and reflux pancreatitis complications was a safe, effective procedure.

PMID:
19715954
[PubMed - indexed for MEDLINE]
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