Laparoscopic resection of perforated duodenal diverticulum – A case report and literature review

Abstract

HighlightsEnglish literatures discussing laparoscopic management for complicated duodenal diverticulum were carefully reviewed.Laparoscopic approach showed less complication, shorted hospital stay and better outcome in comparison to conservative, or open surgery.Laparoscopic approach is safe and feasible in selected cases of complicated duodenal diverticulum (laterally located and protruding duodenal diverticulum), it displays better outcome and many advantages of minimally invasive surgery for the patient.

An innovative method of surgical excision of duodenal diverticulum in a 17-year-old girl

“…Earlier she presented symptoms of chronic abdominal pain and diarrhoea. Indications to the surgery described in the literature comprise: chronic abdominal pain with inflammation, bleeding, perforation, obstructive jaundice, and gastric outlet obstruction [2,[4][5][6]9]. In our patient's case the indication for the procedure was aggravating abdominal pain and progression of the lesion in size.…”

“…Upper GI studies and endoscopy can be of some assistance, but mainly in stable patients. Otherwise, the diagnosis is usually made with intraoperative exploration [6]. Our patient had imaging and endoscopic studies performed due to suspicion of early signs of celiac disease.…”

“…In some cases it was described that the obstruction of the diverticulum was associated with prior ingestion of a foreign body. It was also noted that some DD caused secondary acute pancreatitis with the typical clinical presentation of the disease [4][5][6]. Complications of duodenal diverticula are rare, but they can be severe [2][3][4][5].…”

“…There are several types of treatments described, both surgical or conservative [2,[4][5][6][7]10]. The procedure of choice is duodenotomy with the excision of the diverticulum.…”

“…The procedure of choice is duodenotomy with the excision of the diverticulum. The method of treatment should be chosen according to the patient's condition and the localisation of the DD: segmental duodenectomies, pylorus-preserving pancreaticoduodenectomy (p-p Whipple), and diverticulectomies have been described [2,6,10]. In the presented case the surgery was performed with the innovative use of a laparoscopic method combined with endoscopic control of the surgical field.…”