Jejunuminterponat als Ersatz der Pars descendens duodeni bei ausgedehntem tubulovillösen Adenom

Abstract

Reconstruction after partial duodenectomy with resection of the ampulla of Vater is often troublesome. We report the case of a 70-year-old patient with endoscopically non-resectable tubulo-villous adenoma of the descending duodenum including the ampulla of Vater in which subsequent biopsies revealed dysplastic areas. A partial resection of the descending duodenum including the ampulla of Vater was performed. Reconstruction was achieved by the interposition of a jejunal limb in which the ampulla could be reinserted to the posterior wall. The postoperative course was uneventful; a carcinoma was not found within the specimen. In cases of widespread adenomas of the ampulla of Vater, duodenum-preserving resection by interposition of a jejunal limb with reinsertion of the ampulla into the posterior wall may be used as an alternative to Roux-Y reconstruction and to Whipple's procedure.

Duodenectomy with jejunal advancement and reimplantation of the ampulla of Vater for recurrent right colon cancer: A case report

“…Reconstruction was with the interposition of a jejunal segment to anatomically reconstruct the duodenum. The jejunal segment and ampulla were anastomosed [10]. Young et al reported duodenectomy with reimplantation of the ampulla of Vater into a Roux loop for the successful treatment of megaduodenum [11].…”