Excision duodenoplasty: a new technique for congenital duodenal obstruction

Singh, S.J., Dickson, R., Baskaranathan, S., Peat, J., Spence, K., Kimble, R. and Cass, D. (2002) Excision duodenoplasty: a new technique for congenital duodenal obstruction. Pediatric Surgery International, 18 1: 75-78.


Author Singh, S.J.
Dickson, R.
Baskaranathan, S.
Peat, J.
Spence, K.
Kimble, R.
Cass, D.
Title Excision duodenoplasty: a new technique for congenital duodenal obstruction
Journal name Pediatric Surgery International   Check publisher's open access policy
ISSN 0179-0358
1437-9813
Publication date 2002-01
Sub-type Article (original research)
DOI 10.1007/s003830200020
Volume 18
Issue 1
Start page 75
End page 78
Total pages 4
Editor A. F. Schaerli
Place of publication Berlin
Publisher Springer International
Language eng
Subject C1
110323 Surgery
Abstract Slow anastomotic function is a common problem in the management of congenital duodenal obstruction. We describe a simple technique of excision duodenoplasty (ED) that results in a fixed open anastomosis, which facilitates early commencement of feeds and discharge from hospital. A retrospective case-note review (1981-2000) was undertaken to compare the results of ED with side-to-side duodenoplasty (SSD) and diamond-shaped anastomosis (DD). The outcome measures were days to commencement of feeds, duration of total parenteral nutrition (TPN), and length of hospital stay. In ED a 1.0 to 1.5-cm elleptical segment of dilated duodenum is excised. A longitudinal incision is made in the smaller distal duodenum. A side-to-side one-layer anastomosis is performed. The wall of the proximal duodenal stump is thick, and excision of the ellipse keeps the anastomosis open by preventing apposition or the opposing walls. This facilitates good drainage across the anastomosis. The time to onset of feeding was longer after SSD (median 7 days) compared to ED (5 days) and DD (5 days). The total duration of TPN was also longer for SSD (9 days) in comparison to ED (7 days) and DD (7 days). Although the duration of hospital stay was more for SSD (18 days) than ED (13 days) and DD (16 days), this difference was not statistically significant. The ED technique thus gives an equally good result as DD and a better result than SSD. It is simple to perform and to teach.
Keyword Pediatrics
Surgery
duodenal atresia
duodenal obstruction
duodenal stenosis
duodeno-duodenostomy
duodenoplasty
Diamond-shaped Anastomosis
Atresia
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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