The serosal patch

Jones, Sydney; Gazzaniga, Alan B.; Keller, Thomas B.

doi:10.1016/s0002-9610(73)80152-7

Cited by 35 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two 1,3 articles present cases of giant duodenal ulcer perforation managed by jejunal serosal patches. This technique—originally described in animal models 34–36 —involves bringing a loop of jejunum approximately 40–60 cm distal to the ligament of Treitz over the colon and using this to close the perforation site serosa-to-serosa. A diverting jejunojejunostomy is fashioned.…”

Section: Resultsmentioning

confidence: 99%

Duodenal ulcer perforation: A systematic literature review and narrative description of surgical techniques used to treat large duodenal defects

Clinch

Damaskos

Marzo

et al. 2021

J Trauma Acute Care Surg

View full text Add to dashboard Cite

BACKGROUND There is no consensus on optimal surgical treatment of large duodenal defects arising from perforated ulcers, even though such defects are challenging to repair and inadequate repair is associated with high morbidity and mortality. The aim of this study was to carry out a systematic literature review of different surgical techniques used to treat large duodenal perforations, provide a narrative description of these techniques, and propose a framework for approaching this pathology. METHODS PubMed/MEDLINE database was searched for articles published in English between January 1, 1970, and December 1, 2020. Studies describing surgical techniques used to treat giant duodenal ulcer perforation and their outcomes in adult patients were included. No quantitative analysis was planned because of the heterogeneity across studies. RESULTS Out of 960 identified records, 25 studies were eligible for inclusion. Two randomized controlled trials, one case-control trial, three cohort studies, 14 case series, and 5 case reports were included. Eight main surgical approaches are described, ranging from simple damage-control operations, such as the omental plug and triple-tube techniques, all the way to complex resections, such as gastrectomy. CONCLUSION Evidence on surgical treatment of large duodenal defects is of poor quality, with the majority of studies corresponding to Oxford levels 3b-4. Current evidence does not support any single surgical technique as superior in terms of morbidity or mortality, but choice of technique should be guided by several factors including location of the perforation, degree of duodenal tissue loss, hemodynamic stability of the patient, as well as expertise of the operating surgeon. LEVEL OF EVIDENCE SR with more than two negative criteria, Level IV.

show abstract

Section: Resultsmentioning

confidence: 99%

Duodenal ulcer perforation: A systematic literature review and narrative description of surgical techniques used to treat large duodenal defects

Clinch

Damaskos

Marzo

et al. 2021

J Trauma Acute Care Surg

View full text Add to dashboard Cite

show abstract

“…15 The serosal patch makes use of the serosal surface of adjacent abdominal structures in a manner similar to the omentum to reduce the risk of dehiscence, provide structural support, limit leakage from perforations of hollow viscera, and promote healing by increasing blood supply to areas where it is placed. 26,28,29 In mammals, typically the antimesenteric border of the jejunum is tacked over the area in question by use of monofilament suture material placed in a simple interrupted pattern. 23,30 Sutures must pass through the submucosal, muscularis, and serosal layers but ideally not enter the intestinal lumen.…”

Section: Discussionmentioning

confidence: 99%

Use of a duodenal serosal patch in the repair of a colon rupture in a female Solomon Island eclectus parrot

Briscoe

Bennett²

2011

javma

View full text Add to dashboard Cite

Case Description-A 444-g (0.98-lb) 4-year-old sexually intact female Solomon Island eclectus parrot (Eclectus roratus solomonensis) was referred and evaluated for a suspected colonic obstruction. Clinical Findings-The parrot had a 3-day history of not passing feces and lack of appetite following treatment of dystocia that included percutaneous collapse of the egg and manual removal of egg fragments via the cloaca. During this procedure, a tear in the cloacal mucosa developed. The tear was repaired via a midline cloacotomy. Although clinically stable at the time of referral, the parrot became lethargic and bradycardic and had delayed crop emptying. Treatment and Outcome-A midline celiotomy and cloacotomy were performed to relieve the colonic obstruction, during which the severely distended colon ruptured. The colonic defects were closed in a simple interrupted pattern, and a serosal patch was applied by use of the adjacent duodenum. The bird recovered uneventfully from anesthesia and was passing voluminous feces with mildly increased effort within 1 hour after surgery. At 3 weeks after surgery, the parrot was passing feces with no increase in effort and had a normal appetite. Clinical Relevance-Application of a duodenal serosal patch for repair of a colon rupture was successful in this parrot. Gastrointestinal obstruction is rare in birds, but should be considered in birds that have regurgitation, decreased fecal production, and gastrointestinal dilation. Because birds lack an omentum, serosal patching with adjacent duodenum should be considered as a viable option in avian surgery.

show abstract

“…When the injury is just above or below ampulla of Vater however, resection of the damaged tissue could be difficult. Mucosal or serosal patches and a pedicled graft with a free vascular pedicle created from stomach, jejunum, or ileum tissue have been proposed without proven efficacy in any series [21,22,23,24,25]. Duodenal drainage with a decompression tube, temporary pyloric exclusion, gastrojejunostomy, feeding jejunostomy, gastric resection with external duodenal drainage with Foley or Petzer tubes have also been recommended with conflicting reports of efficacy [26,27,28].…”

Section: Discussionmentioning

confidence: 99%

Management of Descending Duodenal Injuries Secondary to Laparoscopic Cholecystectomy

Testini¹,

Piccinni²,

Lissidini³

et al. 2008

Dig Surg

View full text Add to dashboard Cite

Aim: To report our experience of managing patients affected by descending duodenal injuries secondary to laparoscopic cholecystectomy and to review the literature. Methods: Analysis of 5 cases of descending duodenal injury as a consequence of laparoscopic cholecystectomy managed between June 1992 and September 2006. Results: The median age was 59 (range 49–67) years.In all cases an emergency laparotomy showed an injury to the descending duodenum. Two patients underwent direct suture of the duodenum and external biliary drainage through a T-tube, 1 case underwent a duodenojejunostomy and in another a duodenopancreatectomy. The latter patient underwent drainage of the duodenum with a Petzer tube, followed 5 days later by gastric resection, closure of the duodenal stump and repair of the duodenal wound by suture. The median postoperative stay was 45 days and 1 patient died. Conclusion: Descending duodenal injuries are extremely rare complications of laparoscopic cholecystectomy with potentially fatal consequences if not promptly recognized and treated. The site of the descending duodenal injury is important for determining the surgical approach.

show abstract

The serosal patch

Cited by 35 publications

References 4 publications

Duodenal ulcer perforation: A systematic literature review and narrative description of surgical techniques used to treat large duodenal defects

Duodenal ulcer perforation: A systematic literature review and narrative description of surgical techniques used to treat large duodenal defects

Use of a duodenal serosal patch in the repair of a colon rupture in a female Solomon Island eclectus parrot

Management of Descending Duodenal Injuries Secondary to Laparoscopic Cholecystectomy

Contact Info

Product

Resources

About