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Journal of Gastrointestinal Surgery

, Volume 16, Issue 5, pp 1072–1075 | Cite as

Duodenum–Stomach Anastomosis: a New Technique for Exocrine Drainage in Pancreas Transplantation

  • Marcelo Moura Linhares
  • Reinaldo Isaacs Beron
  • Adriano Miziara Gonzalez
  • Cristian Tarazona
  • Alcides Salzedas
  • Erika Rangel
  • Joao Roberto Sá
  • Claudio Melaragno
  • Suzan Menasce Goldman
  • Marcelo Gonçalves Souza
  • Nelson Y. Sato
  • Delcio Matos
  • Gaspar Jesus Lopes-Filho
  • Jose Osmar Medina
Case Report

Abstract

Introduction

Poor vascular access due to previous surgery can be a major obstacle in pancreas transplantation for which new exocrine and vascular outflow techniques might be useful. A 34-year-old female with early onset type 1 diabetes who underwent living donor kidney transplantation 20 years ago and a failed pancreas transplantation 2 years ago presented for pancreas retransplantation.

Methods

The inferior vena cava was used in the previous deceased donor pancreas transplantation and both iliac arteries had intense perivascular fibrosis, making arterial anastomosis impossible. The only remaining option for the implant was the infrarenal aorta, with venous drainage to the superior mesenteric vein and exocrine drainage to the gastric antrum

Results

The patient had an uneventful recovery and graft function appeared normal. This report shows that when the recipient’s abdominal cavity does not provide clear access for the usual surgical techniques regarding exocrine drainage, the stomach drainage procedure is an option.

Conclusion

Duodenum–stomach anastomosis might be an alternative to portal enteric drainage because there is easy access for graft biopsies and even for procedures involving the papilla major.

Keywords

Iliac Artery Venous Drainage Superior Mesenteric Vein Pancreas Transplantation Live Donor Kidney Transplantation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors gratefully acknowledge Rosaria Ramirez and Sonia Juvenal for their secretarial work and help with the manuscript.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Marcelo Moura Linhares
    • 1
    • 2
  • Reinaldo Isaacs Beron
    • 1
  • Adriano Miziara Gonzalez
    • 1
  • Cristian Tarazona
    • 1
  • Alcides Salzedas
    • 1
  • Erika Rangel
    • 3
  • Joao Roberto Sá
    • 4
  • Claudio Melaragno
    • 3
  • Suzan Menasce Goldman
    • 5
  • Marcelo Gonçalves Souza
    • 1
  • Nelson Y. Sato
    • 1
  • Delcio Matos
    • 1
  • Gaspar Jesus Lopes-Filho
    • 1
  • Jose Osmar Medina
    • 3
  1. 1.Department of SurgeryFederal University of Sao PauloSão PauloBrazil
  2. 2.São PauloBrazil
  3. 3.Department of NephrologyFederal University of Sao PauloSão PauloBrazil
  4. 4.Department of EndocrinologyFederal University of Sao PauloSão PauloBrazil
  5. 5.Department of RadiologyFederal University of Sao PauloSão PauloBrazil

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