Figure 1516

Incidence and procedure in enteric conversion (EC). A, Surgical conversion of pancreatic exocrine secretions from bladder drainage to enteric drainage is necessary in many patients. Whereas half of patients receive EC within the first postoperative year, a significant percentage must undergo EC up to 5 years after transplantation. B, EC involves taking down the duodenocystostomy, repairing the bladder, and performing a simple side-to-side duodenoenterostomy. In our experience of performing 95 ECs over a 14-year period in

480 simultaneous pancreas-kidney (SPK) transplant recipients, only one graft was lost within 3 months of EC [5]. No differences were found in patient, kidney, or pancreas graft survival when comparing SPK transplant recipients who underwent EC with those who did not. The frequency of urologic complications and need for EC have prompted a changing trend toward performing primary enteric drainage; however, neither of these problems appears to impact negatively on graft survival.

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