One of the key issues in successful pancreas transplantation is uncomplicated drainage of pancreas exocrine secretion. OBJECTIVE: The aim of the study is to present results of side-to-side high duodeno-jejunal anastomosis as routine method of enteric drainage in simultaneous pancreas kidney transplantation (SPK). METHODS: 30 diabetic patients underwent SPK at the Department of Surgery, Ruhr University Bochum in 2001. The pancreas was drained using a portion of duodenal segment anastomosed to the first loop of jejunum about 20-40 cm distal to the Treitz ligament. RESULTS: Early relaparotomy was required in 20% patients. The mean time of first relaparotomy was 5.5 (range 1-11) days after transplantation. In 10% of cases graft pancreatectomy was necessary. Perioperative mortality was 3.3%. Currently 83.3% patients are insulin-free and 86.6% patients are free of dialysis. CONCLUSIONS: These data suggest, that side-to-side high duodeno-jejunal anastomosis is a safe method of drainage of pancreas exocrine secretion in SPK.