Bladder drainage of pancreatic exocrine secretions during pancreas transplantation can lead to urological complications.
In this study, physicians from the University of Washington examined their experience with cystoenteric conversion (CEC).
They retrospectively reviewed 255 pancreas transplantations, which were performed between 1990 and 2001. Of these, 236 were bladder drained and 33 required enteric conversion of bladder drainage.
In addition, 21 patients with large capacity bladders underwent concurrent reduction cystoplasty.
The physicians found that the most frequent indication (44%) for CEC was recurrent urinary tract infections.
|Normal pancreatic graft function persisted in 88%.|
|Journal of Urology|
The mean follow-up after CEC was 2.5 years.
Overall, 15% of patients experienced complications requiring reoperation. There was 1 death.
However, normal pancreatic graft function persisted in 88%.
The team found that 88% of patients experienced resolution of symptoms, 9% experienced improvement and 3% continued to have recurrent infections.
Dr Peter Black's team concluded, "Although we advocate maximal conservative treatment of the urological complications of pancreas transplantation, CEC offers safe and effective management of these complications"
"And can easily be combined with reduction cystoplasty in select cases to optimize postoperative voiding function".