{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:46:15Z","timestamp":1765889175523,"version":"3.37.3"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Whole pancreas transplantation provides durable glycemic control and can improve survival rate; however, it can carry an increased risk of surgical complications. One devastating complication is a duodenal leak at the site of enteroenteric anastomosis. The gastroduodenal artery (GDA) supplies blood to the donor duodenum and pancreas but is commonly ligated during procurement. Since we have not had expressive changes in pancreatic back table surgical techniques in the recent decades, we hypothesized whether back table GDA reconstruction, improving perfusion of the donor duodenum and head of the pancreas, could lead to fewer surgical complications in simultaneous pancreas\u2010kidney (SPK) transplants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Between 2017 and 2021, we evaluated demographic information, postoperative complications, intraoperative donor duodenum, recipient bowel O<jats:sub>2<\/jats:sub> tissue saturation, and patient morbidity through the Comprehensive Complication Index (CCI\u00ae).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 26 patients were included: 13 underwent GDA reconstruction (GDA\u2010R), and 13 had GDA ligation (GDA\u2010L). There were no pancreatic leaks in the GR group compared to 38% (5\/13) in the GDA\u2010L group (<jats:italic>p<\/jats:italic>\u2009=\u20090.03913). Intraoperative tissue oxygen saturation was higher in the GDA\u2010R group than in the GDA\u2010L (95.18 vs.76.88%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090,001). We observed an increase in transfusion rate in GDA\u2010R (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), which did not result in a higher rate of exploration (<jats:italic>p<\/jats:italic>\u2009=\u20090.38). CCI\u00ae patient morbidity was also significantly lower in the GDA\u2010R group (<jats:italic>s<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study identified improved intraoperative duodenal tissue oxygen saturation in the GDA\u2010R group with an associated reduction in pancreatic leaks and CCI\u00ae morbidity risk. A larger prospective multicenter study comparing the two methods is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-07149-4","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T18:02:01Z","timestamp":1694541721000},"page":"2846-2856","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Prospective Study of the Effect of Gastroduodenal Artery Reconstruction on Duodenal Oxygenation and Enzyme Content After Pancreas Transplantation"],"prefix":"10.1002","volume":"47","author":[{"given":"Juliano C. M.","family":"Offerni","sequence":"first","affiliation":[{"name":"Department of General Surgery Division of Urology University of Manitoba Winnipeg MB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4244-4518","authenticated-orcid":false,"given":"Erica","family":"Ai Li","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine &amp; Dentistry Western University London ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Alberta Edmonton AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen Y.","family":"Xie","sequence":"additional","affiliation":[{"name":"Division of Transplantation and Hepatobiliary Surgery University of Florida Gainesville FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max A.","family":"Levine","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Alberta Edmonton AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Murkin","sequence":"additional","affiliation":[{"name":"Department of Anesthesia &amp; Perioperative Medicine at Schulich School of Medicine &amp; Dentistry Western University London ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivian C.","family":"McAlister","sequence":"additional","affiliation":[{"name":"Department of General Surgery London Health Sciences Center London ON Canada"},{"name":"University of Western Ontario London ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick P.","family":"Luke","sequence":"additional","affiliation":[{"name":"Division of Urology Schulich School of Medicine &amp; Dentistry London Health Sciences Center LHSC University Hospital Western University C4208, 339 Windermere Road N6A 5A5 London ON Canada"},{"name":"University of Western Ontario London ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alp","family":"Sener","sequence":"additional","affiliation":[{"name":"Division of Urology Schulich School of Medicine &amp; Dentistry London Health Sciences Center LHSC University Hospital Western University C4208, 339 Windermere Road N6A 5A5 London ON Canada"},{"name":"University of Western Ontario London ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"DholakiaS OskrochiY EastonG PapaloisVAdvances in pancreas transplantation.J R Soc Med(2016)10.1177\/0141076816636369270599054827108"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.34172\/hpp.2020.18"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2017.1360312"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010020\u201005263\u20109"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","unstructured":"MittalS GoughSCLPancreas transplantation: a treatment option for people with diabetes.Diabetic Med(2014)10.1111\/dme.1237324313883","DOI":"10.1111\/dme.12373"},{"issue":"2","key":"e_1_2_9_7_1","first-page":"454","article-title":"Operative reintervention following early complications after pancreas transplantation","volume":"26","author":"Troppmann C","year":"1994","journal-title":"Transpl Proc"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.06.165"},{"key":"e_1_2_9_9_1","unstructured":"NghiemDDRevascularization of the gastroepiploic artery in pancreas transplant.Transpl Int(2008)10.1111\/j.1432\u20102277.2008.00683.x18482176"},{"key":"e_1_2_9_10_1","unstructured":"SakuharaY KodamaY AboDet al. Evaluation of the vascular supply to regions of the pancreas on CT during arteriography.Abdom Imaging(2008)10.1007\/s00261\u2010007\u20109342\u2010x18180986"},{"key":"e_1_2_9_11_1","unstructured":"KumarKH GargS YadavTD SahniD SinghH SinghRAnatomy of peripancreatic arteries and pancreaticoduodenal arterial arcades in the human pancreas: a cadaveric study.Surg Radiol Anat(2021)10.1007\/s00276\u2010020\u201002632\u20102345702858536615"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","unstructured":"Garcia\u2010RocaR PomboEAGastroduodenal artery reconstruction as salvage procedure for pancreas head ischemia during transplantation: a case report.Open J Organ Transpl Surg(2012)10.4236\/ojots.2012.24007","DOI":"10.4236\/ojots.2012.24007"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2006.02.020"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","unstructured":"Brice\u00f1oJ S\u00e1nchez\u2010HidalgoJM ArjonaABack\u2010table surgery pancreas allograft for transplantation: implications in complications.World J Transpl(2021)10.5500\/wjt.v11.i1.1","DOI":"10.5500\/wjt.v11.i1.1"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010018\u20102963\u20104"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2008.01.047"},{"key":"e_1_2_9_17_1","unstructured":"FujisakaSI OzakiT SuzukiTet al. A clinical tissue oximeter using NIR time\u2010resolved spectroscopy.Adv Exp Med Biol(2016)10.1007\/978\u20101\u20104939\u20103023\u20104_5426782242"},{"key":"e_1_2_9_18_1","unstructured":"BassiC MarchegianiG DervenisCet al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After.Surgery(2017)10.1016\/j.surg.2016.11.01428676333"},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","unstructured":"AboalsamhG AndersonP Al\u2010AbbassiA McAlisterV LukePP SenerAHeparin infusion in simultaneous pancreas and kidney transplantation reduces graft thrombosis and improves graft survival.Clin Transpl(2016)10.1111\/ctr.12780","DOI":"10.1111\/ctr.12780"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2016.01.091"},{"key":"e_1_2_9_22_1","doi-asserted-by":"crossref","unstructured":"GrochowieckiT Ga\u0142\u0105zkaZ MadejKet al. Surgical complications related to transplanted pancreas after simultaneous pancreas and kidney transplantation.Transpl Proc(2014)10.1016\/j.transproceed.2014.08.012","DOI":"10.1016\/j.transproceed.2014.08.012"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318296c732"},{"key":"e_1_2_9_24_1","unstructured":"HumarA KandaswamyR GrangerD GruessnerRW GruessnerAC SutherlandDEDecreased surgical risks of pancreas transplantation in the modern era.Ann Surg(2000)10.1097\/00000658\u2010200002000\u201000017106746201420996"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318289c978"},{"key":"e_1_2_9_26_1","doi-asserted-by":"crossref","unstructured":"Ib\u00e1\u00f1ezJM RobledoAB L\u00f3pez\u2010AndujarRLate complications of pancreas transplant.World J Transpl(2020)10.5500\/wjt.v10.i12.404","DOI":"10.5500\/wjt.v10.i12.404"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-023-07149-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-023-07149-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-023-07149-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-023-07149-4","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T10:45:39Z","timestamp":1719225939000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-023-07149-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,12]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1007\/s00268-023-07149-4"],"URL":"https:\/\/doi.org\/10.1007\/s00268-023-07149-4","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"type":"print","value":"0364-2313"},{"type":"electronic","value":"1432-2323"}],"subject":[],"published":{"date-parts":[[2023,9,12]]},"assertion":[{"value":"24 July 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}