Enteric to bladder drainage conversion due to duodenal leak following pancreatic transplantation

Abstract

Purpose: Pancreas transplantation remains the only method able to completely reestablish the euglicemic control without using exogen insulin. The pancreatic exocrine drainage is still being discussed. The purpose of this paper is to present a case-report of a patient who underwent a simultaneous pancreas-kidney transplant with enteric drainage, successfully submitted to conversion surgery for bladder drainage due to duodenal leak. Method and Criteria: A 36 years old female patient with diabetes mellitus type 1 for 23 years was submitted to simultaneous pancreas-kidney transplant with enteric drainage. There was a good initial evolution, but the patient presented duodenal leak, being submitted to two surgical interventions. In the second one, the conversion from enteric to bladder drainage was successfully performed. Discussion and Conclusion: The surgical conversion option from enteric to bladder drainage after pancreas transplant is attractive when the risks offered to the patient are compensatory. Patients under potential situations for this procedure are those presenting duodenal leaking after simultaneous pancreas-kidney transplant with enteric drainage.