Excision duodenoplasty: a new technique for congenital duodenal obstruction

被引：0

作者：

S. J. Singh

R. Dickson

S. Baskaranathan

J. Peat

K. Spence

R. Kimble

D. Cass

机构：

[1] Department of Paediatric Surgery,

[2] University Hospital,undefined

[3] Queen's Medical Centre,undefined

[4] Nottingham NG72UH,undefined

[5] UK,undefined

[6] Department of Paediatrics and Child Health Medical Research,undefined

[7] The Children's Hospital at Westmead,undefined

[8] Westmead,undefined

[9] Sydney NSW 2124,undefined

[10] Australia,undefined

[11] Department of Neonatal Medicine,undefined

[12] The Children's Hospital at Westmead,undefined

[13] Westmead,undefined

[14] Sydney NSW 2124,undefined

[15] Australia,undefined

[16] University of Queensland,undefined

[17] Department of Paediatrics and Child Health,undefined

[18] Royal Royal Children's Hospital,undefined

[19] Brisbane QLD 4029,undefined

[20] Australia,undefined

来源：

Pediatric Surgery International | 2002年 / 18卷

关键词：

Keywords Duodenal atresia; Duodenal obstruction; Duodenal stenosis; Duodeno-duodenostomy; Duodenoplasty;

D O I：

暂无

中图分类号：

学科分类号：

摘要：

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 of 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.

引用

页码：75 / 78

页数：3