E M Connolly1, H Osborne, D P Hickey. 1. Department of General Surgery, Beaumont Hospital, Dublin, Ireland. lconnolly@rcsi.ie
Abstract
BACKGROUND: Hereditary pancreatitis is an important cause of chronic pancreatitis, which may result in endocrine and exocrine failure. This may necessitate simultaneous pancreas and kidney transplant (SPK). Bladder drainage of the exocrine secretions may cause problems. AIM: To report one such case and its surgical correction. METHODS: A 20-year-old male with insulin-dependent diabetes mellitus secondary to idiopathic chronic pancreatitis had a SPK with bladder drainage. Urological and metabolic complications secondary to the drainage of pancreatic secretions, rich in proteolytic enzymes required convertion from bladder to enteric drainage. RESULTS: He was able to discontinue his pancreatic enzyme supplements, ceased to have steatorrhoea and gained weight. He was referred to the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC), hereditary pancreatitis was confirmed by genetic analysis. CONCLUSION: Enteric-drained pancreas transplantation is a successful treatment for exocrine as well as endocrine pancreatic failure and should be considered as a treatment option in patients with chronic pancreatitis.
BACKGROUND:Hereditary pancreatitis is an important cause of chronic pancreatitis, which may result in endocrine and exocrine failure. This may necessitate simultaneous pancreas and kidney transplant (SPK). Bladder drainage of the exocrine secretions may cause problems. AIM: To report one such case and its surgical correction. METHODS: A 20-year-old male with insulin-dependent diabetes mellitus secondary to idiopathic chronic pancreatitis had a SPK with bladder drainage. Urological and metabolic complications secondary to the drainage of pancreatic secretions, rich in proteolytic enzymes required convertion from bladder to enteric drainage. RESULTS: He was able to discontinue his pancreatic enzyme supplements, ceased to have steatorrhoea and gained weight. He was referred to the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC), hereditary pancreatitis was confirmed by genetic analysis. CONCLUSION: Enteric-drained pancreas transplantation is a successful treatment for exocrine as well as endocrine pancreatic failure and should be considered as a treatment option in patients with chronic pancreatitis.
Authors: K Truninger; J Köck; H P Wirth; B Muellhaupt; C Arnold; F von Weizsäcker; B Seifert; R W Ammann; H E Blum Journal: Pancreas Date: 2001-01 Impact factor: 3.327