Based on their personal as well as international experiences, the authors describe different surgical techniques employed in pancreatic allograft related to different complications rate and patient and graft outcome. In fact, the surgical technique represents an only partially solved problem, because of the high percentage of complications dealing with the different approaches. Even though several procedures concerning either the site of implantation either the treatment of the exocrine function have been so far used, the results up to now obtained are the main limiting factor for a large clinical application of pancreatic transplantation.

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