Whole organ pancreas transplantation with duodenocystostomy is the most commonly employed technique in the United States. The best method for drainge of the exocrine secretion of the graft remains controversial due to the occurrence of either urologic complications or bowel leaks with sepsis. Some authors have employed a higher rate of enteric conversion due to urologic complications. Doudenal segment complications have emerged as an adverse event of the procedure. We have reviewed our experience with the doudenal segment related complications of 200 consecutive type I diabetic recipients of combined kidney/pancreas transplants (KPT). Hematuria occurred in 11% and bladder leaks 10% of recipients. Non-operative management was feasible in a large number of patients.