Published online Sep 27, 2021. doi: 10.4240/wjgs.v13.i9.988
Peer-review started: March 22, 2021
First decision: May 13, 2021
Revised: May 17, 2021
Accepted: August 10, 2021
Article in press: August 10, 2021
Published online: September 27, 2021
Enteric anastomotic (EA) bleeding is a potentially life-threatening surgical complication associated with enteric anastomosis during simultaneous pancreas and kidney transplantation (SPKT).
To investigate whether suture ligation (SL) for submucosal hemostasis during hand-sewn enteric anastomosis could decrease the morbidity of early EA bleeding in SPKT.
We compared the outcomes of 134 patients classified into SL (n = 44) and no SL (NSL) groups (n = 90). This study adheres to the declarations of Istanbul and Helsinki and all donors were neither paid nor coerced.
During the first postoperative week, the EA bleeding rate in the SL group was lower than that in the NSL group (2.27% vs 15.56%; P = 0.021); no relationship was found between EA bleeding and donor age, mean pancreatic cold ischemia time, platelet count, prothrombin time international normalized rate, activated partial thromboplastin time, and thrombin time. Anastomotic leakage was observed in one case in the SL group at postoperative day (POD) 14 and in one case at POD 16 in the NSL group (P = 0.754). No significant difference was found between the two groups in the patient survival, pancreas graft survival, or kidney graft survival.
SL for submucosal hemostasis during hand-sewn enteric anastomosis in SPKT can decrease the morbidity of early EA bleeding without increasing the anastomotic leakage rate.
Core Tip: Enteric anastomotic (EA) bleeding is a potentially life-threatening complication of simultaneous pancreas and kidney transplantation (SPKT) and can result in graft loss; therefore, it is essential to lower the incidence of EA bleeding. This study aimed to investigate whether suture ligation for submucosal hemostasis during enteric anastomosis could decrease the morbidity of early EA bleeding in SPKT. By comparing the outcomes of patients of suture ligation and no suture ligation groups, we found that suture ligation for submucosal hemostasis during enteric anastomosis in SPKT can decrease the morbidity of early EA bleeding without concurrently increasing the anastomotic leakage rate.