Figure 1510

Enteric drainage (ED) technique. An alternative approach to bladder drainage, ED is, perhaps, a more physiologic method of handling pancreatic exocrine secretions. ED is the preferred method in Europe and is rapidly gaining popularity in the United States [1]. Most commonly, it is performed as depicted without a Roux-en-Y anastomosis. The donor duodenal segment is anastomosed in a side-to-side fashion to the ileum or distal jejunum. Long-term graft survival, thrombosis rates, and primary nonfunction rates are no different when comparing the two techniques [1-3]. Performed with expertise, both techniques should yield excellent results. Several significant advantages of the ED technique over bladder drainage make ED our technique of choice.

Transplantation as Treatment of End-Stage Renal Disease COMPARISON OF BLADDER DRAINAGE VERSUS ENTERIC DRAINAGE TECHNIQUES

Bladder drainage (BD)

Enteric drainage (ED)

Advantages

Advantages

Ability to monitor urinary amylase levels as an indicator of rejection [6]

No need for enteric conversion in up to 25% of patients who have urologic

?Decreased risk of perioperative intra-abdominal infections

complications

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