Segmental auto-transplantation of the pancreas

Abstract

A total pancreatectomy was performed in a 39-year-old man diabetic with diffuse calcification of the whole pancreas, a pseudocyst and intrapancreatic bile duct obstruction. The body of the excised pancreas was immediately transplanted into the left groin. The postoperative responses of plasma glucagon and insulin were not impaired compared with their preoperative responses. The patient was relieved of unremitting pain and is doing well six months after this operation.

Pancreas Transplantation for the Treatment of Pancreatic Exocrine Disorders

“…Subsequently, several modifications for heterotopic pancreas auto transplants were reported: Use of the pancreatic body only, with anastomosis of the proximal splenic vessels to the common femoral vessels and ligation of both ends of the pancreatic duct [85]; staged enteric drainage with a Roux-en-Y anastomosis to the pancreatic duct [86]; extra peritoneal anastomosis of the splenic vessels to the iliac vessels, with primary enteric drainage of the pancreatic duct to a Roux-en-Y loop, with or without temporary placement of a percutaneous stent in the pancreatic duct [87]; and extra peritoneal placement and anastomosis of the splenic vessels to the iliac vessels with pancreaticocystostomy [88].…”

“…The surgical techniques for managing exocrine pancreatic secretions developed in a similar fashion for segmental autotransplants as they did for segmental allotransplants: from duct ligation and duct injection to enteric or bladder drainage. Although improvements in exocrine function cannot be expected by enteric drainage in patients with chronic pancreatitis, enteric drainage may be the choice to preserve the existing level of exocrine function [85].…”