门、肠引流式胰肾一期联合移植5例报告  

One-stage combination of renopancreatic transplantation:a report of 5 cases

作　　者：祝哲诚[1] 彭志海[2] 范昱[2] 李克[2] 裘正军[2] 徐军明[2] 王兆文[2] 徐宁[2] 

机构地区：[1]上海交通大学附属瑞金医院器官移植中心,上海200025 [2]上海交通大学附属第一人民医院器官移植临床医学研究中心,上海200080

出　　处：《中国普通外科杂志》2006年第8期595-598,共4页China Journal of General Surgery

摘　　要：目的总结胰腺内分泌门静脉引流、外分泌肠腔引流式(PE)一期胰、肾联合移植的临床经验。方法对5例1型糖尿病并发尿毒症患者施行PE一期胰、肾联合移植术的临床资料及手术技术和非手术性并发症的预防进行回顾性分析。结果5例手术均获成功,其中3例恢复良好,2例围手术期死亡,分别死于胰漏感染和FK 5 0 6药物中毒。存活者术后3 d血肌酐、尿素氮恢复正常;术后7 d停用胰岛素,移植胰内、外分泌功能正常。结论PE引流式胰腺移植在生理、代谢和免疫学等方面更具优势和合理性;PE式将是胰腺移植优先选择的术式;加强围手术期管理有助于减少术后并发症,取得良好疗效。Objective To summarize the clinical technique and experience of one stage combination of renopancreatic transplantation （SKPT） with portal venous drinage of pancreatic endocrine and enteric drainage of exocrine （PE）. Methods Five patients with insulin-dependent diabetes mellitus and end-stage renal disease underwent SKPT with PE drainage. The clinical data, operative techbuque, and the prevention of non-technical complications were summarized. Results This procedure was successfully applied in the 5 patients. Three patients recovered excellently ; but 2 died perioperatively, one died of sepsis due to pancreatic leakage, and one of FK506 toxicity. On postoperative day 3 , in the 3 survivors, blood creatinine and urea nitrogen levels returned to normal ; insulin administration was discontinued on 7d postoperatively, and the endogenous and exogenous secretory functions of the graft were normal. Conclusions SKPT with PE is a i＇esonable procedure, because of its potential physiologic, metabolic , and immunologic advantages. PE drainage may become the prefer technique of pancreas transplantation. Intensive perioperative managements are effective methods to prevent complications and to improve the therapeutic effects.

关 键 词：胰移植 肾移植 胰肾联合移植 引流术 

分 类 号：R617[医药卫生—外科学] R615[医药卫生—临床医学]