LAPAROSCOPIC-GUIDED BIOPSY OF PANCREATIC TRANSPLANT ALLOGRAFT

Percutaneous and transcystoscopic transplanted pancreatic graft biopsy have now become the best methods in diagnosing graft rejection and dy sfunction. We report our technique of laparoscopic pancreatic graft bi opsy in a case not amenable to standard trancystoscopic or percutaneou s biopsy. Case report: A 44-year-old man underwent enteric conversion of a previous combined bladder-drained kidney-pancreas transplantation for repeated episodes of dehydration. Complaints of polyuria and poly dipsia necessitated biopsies of the grafts to rule out graft rejection . The ultrasound of the pancreas, however, showed multiple bowel loops overlying the graft preventing percutaneous biopsy. The patient was t aken for laparoscopic-guided pancreatic graft biopsy. Discussion: Ente ric-converted pancreatic grafts are not amenable to transcystoscopic b iopsy. These grafts are often covered with loops of small bowel preven ting ultrasound-guided percutaneous biopsy. Until recently, open lapar otomy was performed to biopsy these grafts. We present our method of l aparoscopic-guided pancreatic graft biopsy as an alternative to open l aparotomy. Conclusions: Laparoscopic guided biopsy for pancreatic allo graft transplantation is a safe and effective alternative to open lapa rotomy and should be considered when percutaneous biopsy is hazardous or not possible.