신장-췌장 동시 이식 후의 요관 폐쇄증에 있어서 자기 요관을 이용한 요관요관문합술
Native Ureterotransplant Ureterostomy for Ureteral Obstruction after Simultaneous Pancreas Kidney Transplantation
이삼열, 이재춘, 설진원, 김주섭, 박찬흔, 김승일, 주선형, 이영철, 박성길, 양대열, 김성용, 김호철, 배상훈, 현숙자, 박철재, 윤대원,
소속 상세정보
이삼열 ( Lee Sam-Uel )
한림대학교 의과대학 외과학교실
이재춘 ( Lee Jae-Chun )
한림대학교 의과대학 외과학교실
설진원 ( Seol Jin-Won )
한림대학교 의과대학 외과학교실
김주섭 ( Kim Joo-Seop )
한림대학교 의과대학 외과학교실
박찬흔 ( Park Chan-Heum )
한림대학교 의과대학 외과학교실
김승일 ( Kim Seung-Il )
한림대학교 의과대학 외과학교실
주선형 ( Joo Sun-Hyung )
한림대학교 의과대학 외과학교실
이영철 ( Lee Young-Cheol )
한림대학교 의과대학 외과학교실
박성길 ( Park Sung-Gil )
한림대학교 의과대학 외과학교실
양대열 ( Yang Dae-Yul )
한림대학교 의과대학 비뇨기과학교실
김성용 ( Kim Sung-Yong )
한림대학교 의과대학 비뇨기과학교실
김호철 ( Kim Ho-Chul )
한림대학교 의과대학 방사선과학교실
배상훈 ( Bae Sang-Hoon )
한림대학교 의과대학 진단방사선과학교실
현숙자 ( Hyun Sook-Ja )
한림대학교 의과대학 외과학교실
박철재 ( Park Chul-Jae )
한림대학교 의과대학 외과학교실
윤대원 ( Yoon Dae-Won )
한림대학교 의과대학 외과학교실
KMID : 0371320020630010079
Abstract
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.
키워드
요관요관문합술; 신췌장 동시이식; Native ureterotransplant ureterostomy; Pancreas kidney transplantation;
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