Urological complications after simultaneous renal and pancreatic transplantation.

Elena Orsenigo, Marco Cristallo, Carlo Socci, Renato Castoldi, Antonio Secchi, Renzo Colombo, Laura Invernizzi, Paolo Fiorina, Richard Naspro, Valerio Di Carlo
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引用次数: 9

Abstract

Objective: To report the urological complications after simultaneous renal and pancreatic transplantation.

Design: Retrospective study.

Setting: Teaching hospital, Italy.

Subjects: 143 consecutive patients having simultaneous renal and pancreatic transplantation by one of three techniques. 33 segmental pancreas with duct occlusion, 77 whole pancreas with bladder diversion, and 33 enteric diversion with systemic (n = 26) or portal venous drainage (n = 7). Urological complications were related to the pancreatic transplant, to the renal transplant, or unrelated to the transplant.

Main outcome measures: Morbidity.

Results: After occlusion of the duct and enteric diversion, there were no urological complications related to the pancreatic transplant. On the other hand, among the 77 patients with pancreatic drainage into the bladder, urological complications were common (56/77; 73%). Complications related to the renal transplant were recorded in 6/33 (18%), 26/77 (34%) and 12/33 (36%), respectively. Complications unrelated to the transplant occurred in 6/77 patients (8%) in the bladder drainage group. Five patients after bladder drainage required cystoenteric conversion.

Conclusions: Enteric diversion is a safe alternative to bladder diversion and results in significantly fewer urological complications.

肾胰联合移植术后泌尿系统并发症。
目的:报道肾胰联合移植术后泌尿外科并发症。设计:回顾性研究。环境:意大利教学医院。研究对象:采用三种技术之一同时行肾胰移植的143例患者。33例胰节段性胰管闭塞,77例全胰膀胱导流,33例肠导流全身性引流(26例)或门静脉引流(7例)。泌尿外科并发症与胰移植、肾移植有关,或与移植无关。主要结局指标:发病率。结果:胰管封堵及肠分流后,无胰移植相关泌尿系统并发症。另一方面,在77例胰管引流入膀胱的患者中,泌尿系统并发症较为常见(56/77;73%)。与肾移植相关的并发症分别为6/33(18%)、26/77(34%)和12/33(36%)。膀胱引流组有6/77例(8%)发生与移植无关的并发症。5例患者膀胱引流后需膀胱肠转换。结论:肠分流术是膀胱分流术的一种安全的替代方法,其泌尿系统并发症明显减少。
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