Retroperitoneal pancreas transplantation with portal-enteric drainage

Background. Portal-enteric drainage (PED) is the latest refinement in the surgical technique for pancreas transplantation (PTx). We herein describe the results of a modified technique for PED that places the pancreas in a totally retroperitoneal position. Methods. Between April 2001 and June 2003, 79 PTx were performed using a retroperitoneal PED technique. Results. No graft was lost due to surgical complications and the relaparotomy rate was 11.4%. Mean hospital stay averaged 25.9 days (+/- 14.4 days) with a 30-day redamission rate of 12.7%. One graft was lost due to delayed (6 months) arterial thrombosis and three to acute rejection. The overall 1-year patient and graft survivals were 98.7% and 93.7%, respectively. Conclusions. Our data confirm that PED of pancreas grafts is associated with low morbidity and mortality rates. Whether retroperitoneal graft placement has actual advantages over the "classical" intraperitoneal position remains to be ascertained.