Current status and future advances of intestinal autotransplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Xiang ^1,2 , LIU Shuo ^1,2 , LIAO Tianyi ^1,2 ,  CAI Hui ^1,2,3

1. The First Clinical Medical College, Lanzhou University, Lanzhou 730000, P. R. China;
2. Department of General Surgery, Gansu Provincial People’s Hospital, Lanzhou 730099, P. R. China;
3. Key Laboratory of Molecular Diagnosis and Precision Medicine for Surgical Oncology in Gansu Province, Lanzhou 730000, P. R. China;

Corresponding author：

CAI Hui, Email: caialonteam@163.com

Keywords：

intestinal autotransplantation; vascular reconstruction; ex vivo organ preservation

DOI：

10.7507/1007-9424.202310053

Video：

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Objective To explore the safety and practicality of intestinal autotransplantation (IATx) combined with radical tumor resection in the treatment of intraperitoneal tumors involving vital blood vessels. Method The research progress on indications, preoperative evaluation, ex vivo organ preservation techniques, and mesenteric vascular reconstruction techniques for IATx from January 1996 to August 2023 both domestically and internationally was reviewed. Results The IATx had become a feasible surgical option for the patients with intraperitoneal tumors involving vital blood vessels (more than 180° involving the root of the superior mesenteric artery). The related studies had identified that the intraperitoneal tumors involving vital blood vessels mainly originated from the pancreas, mesentery, and retroperitoneum. Establishing a multidisciplinary team for preoperative assessment of IATx could aid to establish a valuable diagnostic and treatment system. The keypoints of IATx mainly included IATx preparation (cutting and ligating mesenteric blood vessels), in vivo tumor resection, cryopreservation of intestine in vitro, vascular and gastrointestinal reconstruction after IATx, which was different viewpoints in the different literature, such as the selection of in vivo/in vitro tumor resection, mesenteric vascular reconstruction, and portal or vena cava drainage. However, there was a consensus that the optimal solution for ex vivo organ preservation technology was improved solutions relevant to UW. At present, the hot ischemia time of intestine graft was shortened, the incidence of postoperative intestinal graft loss was reduced, and the postoperative survival of patients was gradually extended. But there were still some unresolved complications, such as early graft loss, pancreatic leakage, delayed gastric emptying, postoperative bleeding, etc. Conclusions IATx combined with tumor resection for intraperitoneal tumors involving vital blood vessels is feasible through carefully preoperative evaluation and surgical planning, which could provide a good clinical and prognostic result. But this operation requires higher technical requirements and might only be performed in centers with rich experience in intestinal transplantation.

Citation： ZHANG Xiang, LIU Shuo, LIAO Tianyi, CAI Hui. Current status and future advances of intestinal autotransplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(3): 361-366. doi: 10.7507/1007-9424.202310053 Copy

1.	Wyld L, Audisio RA, Poston GJ. The evolution of cancer surgery and future perspectives. Nat Rev Clin Oncol, 2015, 12(2): 115-124.
2.	Wagner M, Redaelli C, Lietz M, et al. Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma. Br J Surg, 2004, 91(5): 586-594.
3.	Dufay C, Abdelli A, Le Pennec V, et al. Mesenteric tumors: diagnosis and treatment. J Visc Surg, 2012, 149(4): e239-e251.
4.	Kirane A, Crago AM. The importance of surgical margins in retroperitoneal sarcoma. J Surg Oncol, 2016, 113(3): 270-276.
5.	Ouyang G, Zhong X, Cai Z, et al. The short- and long-term outcomes of laparoscopic pancreaticoduodenectomy combining with different type of mesentericoportal vein resection and reconstruction for pancreatic head adenocarcinoma: a Chinese multicenter retrospective cohort study. Surg Endosc, 2023, 37(6): 4381-4395.
6.	Sanjay P, Takaori K, Govil S, et al. ‘Artery-first’ approaches to pancreatoduodenectomy. Br J Surg, 2012, 99(8): 1027-1035.
7.	Mollberg N, Rahbari NN, Koch M, et al. Arterial resection during pancreatectomy for pancreatic cancer: a systematic review and meta-analysis. Ann Surg, 2011, 254(6): 882-893.
8.	Alameddine M, Moghadamyeghaneh Z, Yusufali A, et al. Kidney autotransplantation: between the past and the future. Curr Urol Rep, 2018, 19(3): 7.
9.	Lu Q, Aini A, Tang R, et al. From liver surgery to liver transplant surgery: new developments in autotransplantation. Curr Opin Organ Transplant, 2022, 27(4): 337-345.
10.	Conklin LD, Reardon MJ. Autotransplantation of the heart for primary cardiac malignancy: development and surgical technique. Tex Heart Inst J, 2002, 29(2): 105-108.
11.	李朝龙, 吕祥枝, 赵国湘, 等. 扩大区域胰切除加自体小肠移植治疗胰腺癌一例. 中华外科杂志, 1996, 34(12): 757.
12.	Tzakis AG, De Faria W, Angelis M, et al. Partial abdominal exenteration, ex vivo resection of a large mesenteric fibroma, and successful orthotopic intestinal autotransplantation. Surgery, 2000, 128(3): 486-489.
13.	吴国生, 梁廷波. 自体小肠移植技术的实践与挑战. 中华消化外科杂志, 2021, 20(1): 85-88.
14.	Wu G, Wang X, Zhao Q, et al. Intestinal autotransplantation for neoplasms originating in the pancreatic head with involvement of the superior mesenteric artery. Langenbecks Arch Surg, 2016, 401(8): 1249-1257.
15.	Quintini C, Di Benedetto F, Diago T, et al. Intestinal autotransplantation for adenocarcinoma of pancreas involving the mesenteric root: our experience and literature review. Pancreas, 2007, 34(2): 266-268.
16.	Amano H, Miura F, Toyota N, et al. In situ surgical procedures for locally advanced pancreatic cancer: partial abdominal evisceration and intestinal autotransplantation. J Hepatobiliary Pancreat Surg, 2009, 16(6): 771-776.
17.	Tzakis AG, Pararas NB, Tekin A, et al. Intestinal and multivisceral autotransplantation for tumors of the root of the mesentery: long-term follow-up. Surgery, 2012, 152(1): 82-89.
18.	Nikeghbalian S, Aliakbarian M, Kazemi K, et al. Ex-vivo resection and small-bowel auto-transplantation for the treatment of tumors at the root of the mesentery. Int J Organ Transplant Med, 2014, 5(3): 120-124.
19.	Ravella S, Liou P, Velasco M, et al. Nutritional challenges in patients after intestinal autotransplantation and ex vivo surgery. JPEN J Parenter Enteral Nutr, 2019, 43(2): 245-251.
20.	Wu G, Zhao Q, Li X, et al. Perioperative complications and outcomes after intestinal autotransplantation for neoplasms involving the superior mesenteric artery. J Gastrointest Surg, 2020, 24(3): 650-658.
21.	Raveh Y, Beduschi T, Hosein PJ, et al. Intestinal auto-transplantation and in-situ resection of recurrent pancreatic head intraductal tubulopapillary neoplasm with portal cavernoma: a case report. Transplant Proc, 2021, 53(8): 2598-2601.
22.	Liang T, Zhang Q, Wu G, et al. Radical resection combined with intestinal autotransplantation for locally advanced pancreatic cancer after neoadjuvant therapy: a report of 36 consecutive cases. Ann Surg, 2023, 278(5): e1055-e1062.
23.	Tzvetanov IG, Bhati CS, Jeon H, et al. Segmental intestinal autotransplantation after extensive enterectomy for removal of large intra-abdominal desmoid tumors of the mesentery root: initial experience. Surgery, 2012, 151(4): 621-624.
24.	Wu G, Zhao Q, Wang W, et al. Clinical and nutritional outcomes after intestinal autotransplantation. Surgery, 2016, 159(6): 1668-1676.
25.	Kitchens WH, Elias N, Blaszkowsky LS, et al. Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor. World J Surg Oncol, 2011, 9: 11.
26.	Kato T, Lobritto SJ, Tzakis A, et al. Multivisceral ex vivo surgery for tumors involving celiac and superior mesenteric arteries. Am J Transplant, 2012, 12(5): 1323-1328.
27.	Zeng Y, Wu H, Yang J Y. Small bowel autotransplantation combined with pancreato-duodenectomy for enormous cavernous hemangioma of the small intestine mesentery. Chin Med J (Engl), 2008, 121(20): 2110-2112.
28.	游欣雨, 庞北川, 左邦佑, 等. 改良半离体自体小肠移植治疗肠系膜根部受侵胆管癌1例报道. 中国普外基础与临床杂志, 2023, 30(7): 777-781.
29.	Bockhorn M, Uzunoglu FG, Adham M, et al. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2014, 155(6): 977-988.
30.	Loos M, Kester T, Klaiber U, et al. Arterial resection in pancreatic cancer surgery: effective after a learning curve. Ann Surg, 2022, 275(4): 759-768.
31.	Birgin E, Rasbach E, Téoule P, et al. Impact of intraoperative margin clearance on survival following pancreatoduodenectomy for pancreatic cancer: a systematic review and meta-analysis. Sci Rep, 2020, 10(1): 22178.
32.	Kwon J, Shin SH, Yoo D, et al. Arterial resection during pancreatectomy for pancreatic ductal adenocarcinoma with arterial invasion: a single-center experience with 109 patients. Medicine (Baltimore), 2020, 99(37): e22115.
33.	Liou P, Kato T. Ex vivo resection and autotransplantation for pancreatic neoplasms. Surg Clin North Am, 2018, 98(1): 189-200.
34.	吴国生, 梁廷波. 肿瘤侵犯肠系膜上动脉根治性切除后自体小肠移植行消化道重建的初步思考. 中华外科杂志, 2022, 60(1): 27-31.
35.	Ophir G, Sivan S, Hana S, et al. Abdominal desmoid: course, severe outcomes, and unique genetic background in a large local series. Cancers (Basel), 2021, 13(15): 3673.
36.	Ogawa N, Iseki H, Tsunozaki H, et al. Intra-abdominal desmoid tumor difficult to distinguish from a gastrointestinal stromal tumor: report of two cases. Surg Today, 2014, 44(11): 2174-2179.
37.	Prendergast K, Kryeziu S, Crago AM. The evolving management of desmoid fibromatosis. Surg Clin North Am, 2022, 102(4): 667-677.
38.	Fiore M, Crago A, Gladdy R, et al. The landmark series: desmoid. Ann Surg Oncol, 2021, 28(3): 1682-1689.
39.	Peng PD, Hyder O, Mavros MN, et al. Management and recurrence patterns of desmoids tumors: a multi-institutional analysis of 211 patients. Ann Surg Oncol, 2012, 19(13): 4036-4042.
40.	Munoz P, Bretcha-Boix P, Artigas V, et al. Surgical principles of primary retroperitoneal sarcoma in the era of personalized treatment: a review of the frontline extended surgery. Cancers (Basel), 2022, 14(17): 4091.
41.	Guadagni S, Peri A, Palmeri M, et al. Surgical treatment of recurrent retroperitoneal sarcoma in its different patterns: a 15-years’ two-centers experience. Surgeon, 2023, 21(5): e249-e257.
42.	Salerno KE. Radiation therapy for soft tissue sarcoma: indications, timing, benefits, and consequences. Surg Clin North Am, 2022, 102(4): 567-582.
43.	Keck T, Wellner UF, Bahra M, et al. Pancreatogastrostomy versus pancreatojejunostomy for reconstruction after pancreatoduodenectomy (recopanc, drks 00000767): perioperative and long-term results of a multicenter randomized controlled trial Ann Surg, 2016, 263(3): 440-449.
44.	Mohr A, Brockmann JG, Becker F. HTK-N: modified histidine-tryptophan-ketoglutarate solution-a promising new tool in solid organ preservation. Int J Mol Sci, 2020, 21(18): 6468.
45.	Iwata H, Matsuno N, Ishii D, et al. Applicability of the histidine-tryptophan-ketoglutarate solution as a machine perfusion solution for marginal liver grafts. J Gastroenterol Hepatol, 2023, 38(5): 783-790.
46.	Lautenschläger I, Pless-Petig G, Middel P, et al. Cold storage injury to rat small-bowel transplants-beneficial effect of a modified HTK solution. Transplantation, 2018, 102(10): 1666-1673.
47.	Lai DT, Chu KM, Thompson JF, et al. Islet cell carcinoma treated by induction regional chemotherapy and radical total pancreatectomy with liver revascularization and small bowel autotransplantation. Surgery, 1996, 119(1): 112-114.
48.	Wu G, Wu Y, Wang M, et al. Vascular reconstruction of segmental intestinal grafts using autologous internal iliac vessels. Gastroenterol Rep (Oxf), 2021, 9(4): 350-356.
49.	Berney T, Kato T, Nishida S, et al. Portal versus systemic drainage of small bowel allografts: comparative assessment of survival, function, rejection, and bacterial translocation. J Am Coll Surg, 2002, 195(6): 804-813.
50.	Matsumoto S, Sekine K, Funaoka H, et al. Diagnostic performance of plasma biomarkers in patients with acute intestinal ischaemia. Br J Surg, 2014, 101(3): 232-238.
51.	Davarpanah AH, Ghamari Khameneh A, Khosravi B, et al. Many faces of acute bowel ischemia: overview of radiologic staging. Insights Imaging, 2021, 12(1): 56.
52.	Menahem B, Guittet L, Mulliri A, et al. Pancreaticogastrostomy is superior to pancreaticojejunostomy for prevention of pancreatic fistula after pancreaticoduodenectomy: an updated meta-analysis of randomized controlled trials. Ann Surg, 2015, 261(5): 882-887.
53.	Allen CJ, Yakoub D, Macedo FI, et al. Long-term quality of life and gastrointestinal functional outcomes after pancreaticoduodenectomy. Ann Surg, 2018, 268(4): 657-664.
54.	Hanna MM, Gadde R, Allen CJ, et al. Delayed gastric emptying after pancreaticoduodenectomy. J Surg Res, 2016, 202(2): 380-388.
55.	Kim DK, Hindenburg AA, Sharma SK, et al. Is pylorospasm a cause of delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy?. Ann Surg Oncol, 2005, 12(3): 222-227.

1. Wyld L, Audisio RA, Poston GJ. The evolution of cancer surgery and future perspectives. Nat Rev Clin Oncol, 2015, 12(2): 115-124.
2. Wagner M, Redaelli C, Lietz M, et al. Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma. Br J Surg, 2004, 91(5): 586-594.
3. Dufay C, Abdelli A, Le Pennec V, et al. Mesenteric tumors: diagnosis and treatment. J Visc Surg, 2012, 149(4): e239-e251.
4. Kirane A, Crago AM. The importance of surgical margins in retroperitoneal sarcoma. J Surg Oncol, 2016, 113(3): 270-276.
5. Ouyang G, Zhong X, Cai Z, et al. The short- and long-term outcomes of laparoscopic pancreaticoduodenectomy combining with different type of mesentericoportal vein resection and reconstruction for pancreatic head adenocarcinoma: a Chinese multicenter retrospective cohort study. Surg Endosc, 2023, 37(6): 4381-4395.
6. Sanjay P, Takaori K, Govil S, et al. ‘Artery-first’ approaches to pancreatoduodenectomy. Br J Surg, 2012, 99(8): 1027-1035.
7. Mollberg N, Rahbari NN, Koch M, et al. Arterial resection during pancreatectomy for pancreatic cancer: a systematic review and meta-analysis. Ann Surg, 2011, 254(6): 882-893.
8. Alameddine M, Moghadamyeghaneh Z, Yusufali A, et al. Kidney autotransplantation: between the past and the future. Curr Urol Rep, 2018, 19(3): 7.
9. Lu Q, Aini A, Tang R, et al. From liver surgery to liver transplant surgery: new developments in autotransplantation. Curr Opin Organ Transplant, 2022, 27(4): 337-345.
10. Conklin LD, Reardon MJ. Autotransplantation of the heart for primary cardiac malignancy: development and surgical technique. Tex Heart Inst J, 2002, 29(2): 105-108.
11. 李朝龙, 吕祥枝, 赵国湘, 等. 扩大区域胰切除加自体小肠移植治疗胰腺癌一例. 中华外科杂志, 1996, 34(12): 757.
12. Tzakis AG, De Faria W, Angelis M, et al. Partial abdominal exenteration, ex vivo resection of a large mesenteric fibroma, and successful orthotopic intestinal autotransplantation. Surgery, 2000, 128(3): 486-489.
13. 吴国生, 梁廷波. 自体小肠移植技术的实践与挑战. 中华消化外科杂志, 2021, 20(1): 85-88.
14. Wu G, Wang X, Zhao Q, et al. Intestinal autotransplantation for neoplasms originating in the pancreatic head with involvement of the superior mesenteric artery. Langenbecks Arch Surg, 2016, 401(8): 1249-1257.
15. Quintini C, Di Benedetto F, Diago T, et al. Intestinal autotransplantation for adenocarcinoma of pancreas involving the mesenteric root: our experience and literature review. Pancreas, 2007, 34(2): 266-268.
16. Amano H, Miura F, Toyota N, et al. In situ surgical procedures for locally advanced pancreatic cancer: partial abdominal evisceration and intestinal autotransplantation. J Hepatobiliary Pancreat Surg, 2009, 16(6): 771-776.
17. Tzakis AG, Pararas NB, Tekin A, et al. Intestinal and multivisceral autotransplantation for tumors of the root of the mesentery: long-term follow-up. Surgery, 2012, 152(1): 82-89.
18. Nikeghbalian S, Aliakbarian M, Kazemi K, et al. Ex-vivo resection and small-bowel auto-transplantation for the treatment of tumors at the root of the mesentery. Int J Organ Transplant Med, 2014, 5(3): 120-124.
19. Ravella S, Liou P, Velasco M, et al. Nutritional challenges in patients after intestinal autotransplantation and ex vivo surgery. JPEN J Parenter Enteral Nutr, 2019, 43(2): 245-251.
20. Wu G, Zhao Q, Li X, et al. Perioperative complications and outcomes after intestinal autotransplantation for neoplasms involving the superior mesenteric artery. J Gastrointest Surg, 2020, 24(3): 650-658.
21. Raveh Y, Beduschi T, Hosein PJ, et al. Intestinal auto-transplantation and in-situ resection of recurrent pancreatic head intraductal tubulopapillary neoplasm with portal cavernoma: a case report. Transplant Proc, 2021, 53(8): 2598-2601.
22. Liang T, Zhang Q, Wu G, et al. Radical resection combined with intestinal autotransplantation for locally advanced pancreatic cancer after neoadjuvant therapy: a report of 36 consecutive cases. Ann Surg, 2023, 278(5): e1055-e1062.
23. Tzvetanov IG, Bhati CS, Jeon H, et al. Segmental intestinal autotransplantation after extensive enterectomy for removal of large intra-abdominal desmoid tumors of the mesentery root: initial experience. Surgery, 2012, 151(4): 621-624.
24. Wu G, Zhao Q, Wang W, et al. Clinical and nutritional outcomes after intestinal autotransplantation. Surgery, 2016, 159(6): 1668-1676.
25. Kitchens WH, Elias N, Blaszkowsky LS, et al. Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor. World J Surg Oncol, 2011, 9: 11.
26. Kato T, Lobritto SJ, Tzakis A, et al. Multivisceral ex vivo surgery for tumors involving celiac and superior mesenteric arteries. Am J Transplant, 2012, 12(5): 1323-1328.
27. Zeng Y, Wu H, Yang J Y. Small bowel autotransplantation combined with pancreato-duodenectomy for enormous cavernous hemangioma of the small intestine mesentery. Chin Med J (Engl), 2008, 121(20): 2110-2112.
28. 游欣雨, 庞北川, 左邦佑, 等. 改良半离体自体小肠移植治疗肠系膜根部受侵胆管癌1例报道. 中国普外基础与临床杂志, 2023, 30(7): 777-781.
29. Bockhorn M, Uzunoglu FG, Adham M, et al. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2014, 155(6): 977-988.
30. Loos M, Kester T, Klaiber U, et al. Arterial resection in pancreatic cancer surgery: effective after a learning curve. Ann Surg, 2022, 275(4): 759-768.
31. Birgin E, Rasbach E, Téoule P, et al. Impact of intraoperative margin clearance on survival following pancreatoduodenectomy for pancreatic cancer: a systematic review and meta-analysis. Sci Rep, 2020, 10(1): 22178.
32. Kwon J, Shin SH, Yoo D, et al. Arterial resection during pancreatectomy for pancreatic ductal adenocarcinoma with arterial invasion: a single-center experience with 109 patients. Medicine (Baltimore), 2020, 99(37): e22115.
33. Liou P, Kato T. Ex vivo resection and autotransplantation for pancreatic neoplasms. Surg Clin North Am, 2018, 98(1): 189-200.
34. 吴国生, 梁廷波. 肿瘤侵犯肠系膜上动脉根治性切除后自体小肠移植行消化道重建的初步思考. 中华外科杂志, 2022, 60(1): 27-31.
35. Ophir G, Sivan S, Hana S, et al. Abdominal desmoid: course, severe outcomes, and unique genetic background in a large local series. Cancers (Basel), 2021, 13(15): 3673.
36. Ogawa N, Iseki H, Tsunozaki H, et al. Intra-abdominal desmoid tumor difficult to distinguish from a gastrointestinal stromal tumor: report of two cases. Surg Today, 2014, 44(11): 2174-2179.
37. Prendergast K, Kryeziu S, Crago AM. The evolving management of desmoid fibromatosis. Surg Clin North Am, 2022, 102(4): 667-677.
38. Fiore M, Crago A, Gladdy R, et al. The landmark series: desmoid. Ann Surg Oncol, 2021, 28(3): 1682-1689.
39. Peng PD, Hyder O, Mavros MN, et al. Management and recurrence patterns of desmoids tumors: a multi-institutional analysis of 211 patients. Ann Surg Oncol, 2012, 19(13): 4036-4042.
40. Munoz P, Bretcha-Boix P, Artigas V, et al. Surgical principles of primary retroperitoneal sarcoma in the era of personalized treatment: a review of the frontline extended surgery. Cancers (Basel), 2022, 14(17): 4091.
41. Guadagni S, Peri A, Palmeri M, et al. Surgical treatment of recurrent retroperitoneal sarcoma in its different patterns: a 15-years’ two-centers experience. Surgeon, 2023, 21(5): e249-e257.
42. Salerno KE. Radiation therapy for soft tissue sarcoma: indications, timing, benefits, and consequences. Surg Clin North Am, 2022, 102(4): 567-582.
43. Keck T, Wellner UF, Bahra M, et al. Pancreatogastrostomy versus pancreatojejunostomy for reconstruction after pancreatoduodenectomy (recopanc, drks 00000767): perioperative and long-term results of a multicenter randomized controlled trial Ann Surg, 2016, 263(3): 440-449.
44. Mohr A, Brockmann JG, Becker F. HTK-N: modified histidine-tryptophan-ketoglutarate solution-a promising new tool in solid organ preservation. Int J Mol Sci, 2020, 21(18): 6468.
45. Iwata H, Matsuno N, Ishii D, et al. Applicability of the histidine-tryptophan-ketoglutarate solution as a machine perfusion solution for marginal liver grafts. J Gastroenterol Hepatol, 2023, 38(5): 783-790.
46. Lautenschläger I, Pless-Petig G, Middel P, et al. Cold storage injury to rat small-bowel transplants-beneficial effect of a modified HTK solution. Transplantation, 2018, 102(10): 1666-1673.
47. Lai DT, Chu KM, Thompson JF, et al. Islet cell carcinoma treated by induction regional chemotherapy and radical total pancreatectomy with liver revascularization and small bowel autotransplantation. Surgery, 1996, 119(1): 112-114.
48. Wu G, Wu Y, Wang M, et al. Vascular reconstruction of segmental intestinal grafts using autologous internal iliac vessels. Gastroenterol Rep (Oxf), 2021, 9(4): 350-356.
49. Berney T, Kato T, Nishida S, et al. Portal versus systemic drainage of small bowel allografts: comparative assessment of survival, function, rejection, and bacterial translocation. J Am Coll Surg, 2002, 195(6): 804-813.
50. Matsumoto S, Sekine K, Funaoka H, et al. Diagnostic performance of plasma biomarkers in patients with acute intestinal ischaemia. Br J Surg, 2014, 101(3): 232-238.
51. Davarpanah AH, Ghamari Khameneh A, Khosravi B, et al. Many faces of acute bowel ischemia: overview of radiologic staging. Insights Imaging, 2021, 12(1): 56.
52. Menahem B, Guittet L, Mulliri A, et al. Pancreaticogastrostomy is superior to pancreaticojejunostomy for prevention of pancreatic fistula after pancreaticoduodenectomy: an updated meta-analysis of randomized controlled trials. Ann Surg, 2015, 261(5): 882-887.
53. Allen CJ, Yakoub D, Macedo FI, et al. Long-term quality of life and gastrointestinal functional outcomes after pancreaticoduodenectomy. Ann Surg, 2018, 268(4): 657-664.
54. Hanna MM, Gadde R, Allen CJ, et al. Delayed gastric emptying after pancreaticoduodenectomy. J Surg Res, 2016, 202(2): 380-388.
55. Kim DK, Hindenburg AA, Sharma SK, et al. Is pylorospasm a cause of delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy?. Ann Surg Oncol, 2005, 12(3): 222-227.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Current status and future advances of intestinal autotransplantation

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