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Standard Open Procedures from Deceased Donors

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Transplantation of the Pancreas

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Abstract

Improvements in pancreas transplantation over time were in large part the result of continued progress in developing new or refining existing surgical techniques. No other abdominal organ shows such a wide variety of surgical techniques for the purpose of transplantation. Since the first pancreas transplant in 1966, the surgical focus has been on determining the optimal management for drainage of pancreatic exocrine secretions and venous outflow. While enteric drainage and systemic drainage are now the two most common techniques used, portal vein and other forms of gastro-intestinal drainage (via the small bowel, duodenum, or stomach) as well as bladder drainage are viable options and are considered complementary, rather than competing, alternatives. Hence, the surgical technique should be adapted to the individual circumstances of donor and recipient and to the individual surgeon’s preference to accomplish optimal outcome. Improvements in immunosuppressive therapy and antimicrobial prophylaxis and therapy have added additional safety nets to the various surgical techniques and contributed to a significant decrease in technical complications and failures. From a technical perspective, pancreas transplants can be quite demanding and require solid skills in general and vascular surgery: graft pancreatectomies, pancreas re-transplants, pancreas transplants after native pancreatectomy, living donor and split pancreas transplants, and pancreas transplants in combination with other extra-renal organs such as the liver or lung can be extremely challenging. The evolution of pancreas transplantation with its many technical facets including robotic surgery has also greatly advanced the field of pancreatic surgery at large.

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  1. Department of Surgery, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA

    Rainer W. G. Gruessner

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    Rainer W. G. Gruessner

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    Angelika C. Gruessner

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Gruessner, R.W.G. (2023). Standard Open Procedures from Deceased Donors. In: Gruessner, R.W.G., Gruessner, A.C. (eds) Transplantation of the Pancreas. Springer, Cham. https://doi.org/10.1007/978-3-031-20999-4_29

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