Suture ligation for submucosal hemostasis during hand-sewn side-to-side duodeno-ileostomy in simultaneous pancreas and kidney transplantation

Figure 1 Revascularization of the pancreas and kidney with a single arterial conduit. The donor duodenum segment was anastomosed side-to-side to the recipient’s distal ileum. CHA: Common hepatic artery; GDA: Gastroduodenal arterial; SMA: Superior mesenteric artery.

Figure 2 Suture ligation for submucosal hemostasis. A: Bleeding at the cut edge of the duodenum; B: Bleeding spots of the duodenum were staunched by transmural suture ligation; C: Bleeding at the cut edge of the ileum; D: Bleeding spots of the ileum were staunched by transmural suture ligation. White arrow: Knot of suture thread.

Figure 3 Comparison of clinical features within 1 wk postoperatively in gastrointestinal bleeding and no gastrointestinal bleeding group. A: Donor age; B: Mean pancreatic graft cold ischemia time; C: Platelet count; D: Prothrombin time international normalized rate; E: Activated partial thromboplastin time; F: Thrombin time. GI: Gastrointestinal; INR: International normalized rate.

Figure 4 The Kaplan–Meier curves for patient, kidney graft, and pancreas graft in suture ligation and no suture ligation group. A: Patient survival curves; B: Kidney graft survival curves; C: Pancreas graft survival curves. SL: Suture ligation; NSL: No suture ligation.