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KMID : 0371320020630010079
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Journal of the Korean Surgical Society
2002 Volume.63 No. 1 p.79 ~ p.83
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Native Ureterotransplant Ureterostomy for Ureteral Obstruction after Simultaneous Pancreas Kidney Transplantation
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Lee Sam-Uel
Lee Jae-Chun
Seol Jin-Won
Kim Joo-Seop
Park Chan-Heum
Kim Seung-Il
Joo Sun-Hyung
Lee Young-Cheol
Park Sung-Gil
Yang Dae-Yul
Kim Sung-Yong
Kim Ho-Chul
Bae Sang-Hoon
Hyun Sook-Ja
Park Chul-Jae
Yoon Dae-Won
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Abstract
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Significant surgical complications occur in about half of patients after simultaneous pancreas kidney transplantation (SPK) with bladder drainage. Urologic complications are very common in bladder-drained pancreas transplants. Urinary obstruction
occurs
in either the early or the late period following transplantation. Predictors of urological complications after transplantation have not been well established. Early obstruction is usually diagnosed by an increment of serum creatinine or through
imaging
studies, such as ultrasound and antegrade pyelogram. Surgical management is inevitable when conservative managements fails. If the length of the donor ureter is sufficient, it is possible to redo the ureteroneocystostomy. However, if this is not
the
case or the stricture is at a high level, a native ureterotransplant ureterostomy may be the procedure of choice. SPK was performed on a 36 year old male patient with insulin dependent diabetes mellitus and diabetic nephropathy. The pancreatic
exocrine
secretion was drained by duodenocystostomy. The patient developed an obstruction in upper ureter on the postoperative 16th day. On the postoperative 32nd day, a native ureterotransplant ureterostomy with a double J stent was performed. The
postoperative
course was uneventful. The double J stent was removed on postoperative 112nd day by cystoscope. A subsequent follow up showed excellent pancreatic and renal function.
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KEYWORD
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