End‐to‐end anastomosis using a surgical instrument after a segmental resection of the distal duodenum

Toh, Yasushi; Yamamoto, Manabu; Endo, Kazuya; Ikeda, Yasuharu; Baba, Hideo; Kohnoe, Shunji; Okamura, Tomonori

doi:10.1002/jso.20002

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…Followed removal of lesions, restoring continuity of the duodenum became imperative. By reviewing our data and referring to relevant literatures [ 8 – 11 ], we classified duodenum-jejunal anastomosis as three procedures, (Fig. 2 ) but which one was more advantageous was still controversial.…”

Section: Discussionmentioning

confidence: 99%

“…It leads to the progressive distention of the cul-de-sac, which produces definite pouch of stasis and bacterial infection [ 13 ]. In principle, the reconstruction of the gastrointestinal tract should be performed by end-to-end anastomosis whenever possible, and a blind pouch should be avoided as much as possible to prevent the development of the blind pouch syndrome [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Which style of duodenojejunostomy is better after resection of distal duodenum

Liu

Wang

et al. 2022

BMC Surg

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Background Distal duodenal resections are sometimes necessary for radical surgery, but how to restore duodenal continuity is still unclear. This study aimed at determining which style of anastomosis was more suitable for the duodenojejunostomy after resection of distal duodenum. Patients and methods We retrospectively identified 34 patients who underwent distal duodenum resection at our center between January 2014 and December 2021. According to whether the end or the side of the proximal duodenum was involved in reconstruction, duodenojejunostomy were classified as End style (E-style) and Side style (S-style). Demographic data, clinicopathological details, and postoperative complications were analyzed between two groups. Results Thirteen patients (38.2%) received E-style duodenojejunostomy, and 21 patients (62.8%) received S-style duodenojejunostomy. Comparative analysis showed that in group of E-style, patients had a lower rate of multivisceral resection(5/13 vs 18/21; P = 0.008), delayed gastric emptying (DGE) (1/13 vs 11/21; P = 0.011) and intraperitoneal infection (2/13 vs 12/21; P = 0.03). In this study, the incidence of major complications was up to 35.3% (12/34) and no patient died of complication in perioperative period. In two group, there was no difference in the incidence of major complications (E-style vs S-style: 3/13 vs 9/21; P = 0.292). Conclusions The E-style duodenojejunostomy for the reconstruction of distal duodenum resection is safe and feasible. The E-style anastomosis may have potential value in decreasing the occurrence of complications such as DGE and intraperitoneal infection, and the definitive advantages still need to be verified.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Which style of duodenojejunostomy is better after resection of distal duodenum

Liu

Wang

et al. 2022

BMC Surg

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Localised duodenal and proximal jejunal resections

Kumar

Bhogal

2021

The American Journal of Surgery

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Surgical approach for tumours of the third and fourth part of the duodenum. Distal pancreas-sparing duodenectomy

García‐Molina

Mateo-Vallejo

Franco-Osorio

et al. 2015

International Journal of Surgery

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The anatomic complexity of the duodenum makes surgical resection challenging. We describe our experience with distal pancreas-sparing duodenectomy (PSD) for tumours that arise in the third and fourth parts of the duodenum. Between July 2008 and January 2012 eight patients underwent surgical resection for tumours in the distal parts of the duodenum. Short and long-term outcomes of treatment are retrospectively analyzed. We used the Cattell and Braash surgical approach in six patients. Seven patients underwent a segmental resection of the distal duodenum with a duodenojejunal anastomosis and in one case we performed a wedge local excision with primary closure. There were 5 gastrointestinal stromal tumours (GIST), 1 primary duodenal adenocarcinoma, 1 metastasis of a lung adenocarcinoma and 1 patient with malignant duodenocolic fistula caused by advanced sigmoid colon carcinoma. Median operating time was 200 min and median intraoperatory blood loss 162 mL. Three patients showed postoperative complications and one of them died. There was no reoperation. Median hospital stay was 10 days (range, 7-28 days). The patient with primary adenocarcinoma died after 12 months due to hepatic metastases. All of five patients with GIST are alive without recurrence (mean follow up of 65.6 months), as well as the patient with metastatic duodenal infiltration (45 months after surgery). Segmental resection of the third and fourth portions of the duodenum is reliable and feasible. The Cattell and Braash manoeuvre provides a good exposure and makes this kind of resection easier.

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End‐to‐end anastomosis using a surgical instrument after a segmental resection of the distal duodenum

Cited by 4 publications

References 6 publications

Which style of duodenojejunostomy is better after resection of distal duodenum

Which style of duodenojejunostomy is better after resection of distal duodenum

Localised duodenal and proximal jejunal resections

Surgical approach for tumours of the third and fourth part of the duodenum. Distal pancreas-sparing duodenectomy

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