Pancreatic autotransplantation: duct drainage to bladder, duodenum, stomach, compared to duct ligation or free drainage into the peritoneal cavity.

The pancreas of the dog was divided into segments of left lobe (tail), body and uncinate, but with in-situ blood supply to each segment intact, and comparisons within the same dog were made of various techniques of handling the pancreatic duct. Ligating the duct or allowing it to drain freely into the peritoneal cavity were both associated with high morbidity and severe pancreatitis and fibrosis with exocrine and ultimately, endocrine atrophy. Duct drainage by a duct to mucosal anastomotic technique, whether to stomach, small bowel or urinary bladder, prevents pancreatitis and preserves normal exocrine and endocrine function. A facile technique of pancreatic duct to urinary bladder anastomosis using the uncinate process is described and the lack of deleterious effect of pancreatic exocrine secretions on the uroepithelium is confirmed.