A Single‐Centre Experience of Roux‐en‐Y Enteric Drainage for Pancreas Transplantation

Exocrine drainage following pancreas transplantation can be achieved by drainage into the bladder or bowel, the latter typically by direct duodeno-jejunostomy; the use of Roux-en-Y enteric drainage is uncommon. We report a retrospective analysis of a single centre experience of Roux-en-Y enteric drainage following pancreas transplantation. Over a 14-year period (2001- 2015), 204 consecutive adult pancreas transplants were performed (96.6% simultaneous pancreas and kidney transplants), of which 26.0% were from donors after circulatory death (DCD). During a median follow-up of 67 months (range 13-183 months), 14 (6.9%) recipients experienced complications related to their enteric drainage. Complications during follow up included early enteric anastomotic haemorrhage (five patients), non-anastomotic enteric bleeding (one patient), small bowel obstruction (four patients) and graft duodenal perforation (two within six weeks, five beyond 12 months). No recipient lost their graft as a direct result of complications related to enteric drainage. Patient and pancreas graft survival at one year was 99.0% and 94.0% and at 5 years 91.3% and 84.9% respectively. We conclude that Roux-en-Y enteric drainage following pancreas transplantation is a safe and effective procedure, and facilitates graft salvage in the event of graft duodenal perforation. This article is protected by copyright. All rights reserved.