Document Detail


Compative study of bladder versus enteric drainage in pancreas transplantation.
MedLine Citation:
PMID:  19715953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: There is some controversy concerning the choice of best technique for drainage of exocrine secretions in pancreas transplantation. We compared patients with bladder drainage (BD) versus those with enteric drainage (ED). PATIENTS AND METHODS: From March 1995 to September 2008, 118 patients (68 men and 50 women) of overall mean age of 37.8 +/- 7.8 years underwent pancreas transplantation. There were 109 simultaneous pancreas-kidney, and 9 pancreas after kidney procedures. Recipients were divided in a BD (n = 66 patients) and an ED group (n = 52). RESULTS: Donor characteristics were similar in both groups. Thirty-two patients (48.5%) of the BD group versus none in the ED group experienced urinary tract infections (UTI; P < .001), and 16 patients (24.2%) BD versus 15 (29.4%) ED developed intraabdominal infections (P = NS). The overall rate of relaparotomies was 33.9% (n = 40): 34.8% (n = 23) in the BD versus 32.7% (n = 17) in the ED group (P = NS). Thirty patients (25.4%) lost their pancreas grafts: 21 (31.8%) in the BD group versus 9 (17.3%) in the ED group (P = .055). The acute rejection rates were 12.7%; namely, 15.2% in the BD versus 9.8% in the ED (P = NS). Three-year patient and graft survivals were equivalent in both groups: 96.1% and 65.3% in the BD versus 89.0% and 74.0% in the ED group, respectively (P = NS). CONCLUSIONS: ED is a good alternative to BD for drainage of pancreatic graft exocrine secretions because both techniques have the same patient and graft survival, but BD is associated with a significantly higher rate of UTI and urologic complications.
Authors:
C Jim??nez-Romero; A Manrique; J C Meneu; F Cambra; A Andr??s; J M Morales; E Gonz??lez; E Hern??ndez; E Morales; M Praga; E Gutierrez; E Moreno
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  41     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-08-31     Completed Date:  2010-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2466-8     Citation Subset:  IM    
Affiliation:
Servicio de Cirug??a General y Trasplante de Organos Abdominales, Hospital Doce de Octubre, Madrid, Spain. carlos.jimenez@inforboe.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Diabetes Mellitus, Type 1 / surgery
Diabetes Mellitus, Type 2 / surgery
Diabetic Nephropathies / surgery
Drainage / methods*
Female
Graft Survival
Humans
Kidney Transplantation / adverse effects,  methods
Male
Middle Aged
Pancreas Transplantation / adverse effects,  methods*
Postoperative Complications / epidemiology
Retrospective Studies
Tissue Donors / statistics & numerical data
Urinary Bladder / surgery*
Urinary Tract Infections / epidemiology
Urologic Diseases / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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