Orthotopic placement of a segmental pancreas graft for transplant: a case report

Pancreas retransplantation has become more frequent and represents a technical challenge for surgeons. Knowledge of alternative surgical options could be useful in difficult cases. We present a case of brutal diabetes mellitus in a patient with severe vascular disease that underwent a third pancreas transplant. Difficulties in obtaining arterial inflow were solved utilizing the native splenic vessels, placing the graft in orthotopic position, and a combination of historical surgical techniques in pancreas transplantation; that is, segmental grafts and duct injection for exocrine management made transplantation successful.