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However, pancreatic transplantation has become debatable following the improvements in the results of islet transplantation and artificial pancreas. Therefore, surgeons who perform pancreas transplants require the best surgical technique that can minimize technical failure. We aimed to report our experiences with pancreatic transplantations.<\/jats:p><jats:p>We transplanted 65 pancreatic grafts between 2015 and 2020. Except for one death due to hypoxic brain damage after surgery, no postoperative technical failure was observed. We usually perform duodeno\u2010duodenal anastomosis using the transperitoneal approach, with retrocolic placement of the graft pancreas.<\/jats:p><jats:p>There was no leakage from the duodenum even after immunologic graft failure. To prevent venous thrombosis, which is the most common cause of technical failure, we used the inferior vena cava for anastomosis and added graft venoplasty with a patch of donor vena cava or aortic interposition graft to the bench procedure; subsequently, there were no cases of technical failure due to thrombosis post\u2010transplantation. Therefore, the 1\u2010year graft survival (insulin\u2010free) rate was more than 95%. The improving the surgical technique will maintain pancreatic transplantation as the best treatment for insulin\u2010dependent diabetes.<\/jats:p>","DOI":"10.1111\/ctr.14455","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T09:55:25Z","timestamp":1628848525000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Technical factors that minimize the occurrence of early graft failure in pancreas transplantation"],"prefix":"10.1111","volume":"35","author":[{"given":"Je Ho","family":"Ryu","sequence":"first","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery and Transplantation Department of Surgery Pusan National University Yangsan Hospital Pusan National University School of Medicine  Yangsan Korea"},{"name":"Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital  Yangsan 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