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Chirurgia (Bucharest, Romania : 1990) Oct 2022Duodenal perforation is a life-threatening condition and ideal approaches for the management of duodenal perforations are nowadays unclear, so numerous variables must... (Review)
Review
Duodenal perforation is a life-threatening condition and ideal approaches for the management of duodenal perforations are nowadays unclear, so numerous variables must be considered. Peptic ulcer disease is the most common disease determining a duodenal perforation, however, there may be other less common causes. We retrospectively analyzed all the patients who presented at our Division of General Surgery for a Duodenal Perforation, from September 2018 to December 2019. We focused on patients requiring a tube duodenostomy. Five patients were included in this study. Five patients suffering from a duodenal perforation were analyzed and their data collected. All patients were treated with tube duodenostomy, pyloric exclusion and omega loop gastro-enteroanastomosis. The duodenostomy was removed four weeks after surgery. All patients suffered postsurgical complications ranging from wound infection to pneumonitis; the incidence of severe complications was greater in the older patients. We did not record any deaths four months after the operation. The tube duodenostomy is an old and dated procedure but simple to implement, which may require an increase in post-operative hospitalization, but which subsists as an effective and safe way to treat patients in critical conditions.
Topics: Humans; Duodenostomy; Retrospective Studies; Treatment Outcome; Duodenal Ulcer; Peptic Ulcer Perforation
PubMed: 36318690
DOI: 10.21614/chirurgia.2787 -
Journal of Visceral Surgery Sep 2017
Review
Topics: Combined Modality Therapy; Duodenal Ulcer; Duodenostomy; Female; Gastroenterostomy; Humans; Male; Patient Safety; Peptic Ulcer Perforation; Risk Assessment; Treatment Outcome
PubMed: 28648646
DOI: 10.1016/j.jviscsurg.2017.05.010 -
International Surgery 1988Four patients were admitted to the Surgical Ward because of massive bleeding from a duodenal ulcer. In three the ulcer was induced by non-steroid anti-inflammatory...
Four patients were admitted to the Surgical Ward because of massive bleeding from a duodenal ulcer. In three the ulcer was induced by non-steroid anti-inflammatory drugs. On operation, following pylorotomy and suture of the bleeding artery, neither drainage nor stump closure could be affected safely. Partial gastrectomy with vagotomy, or high subtotal gastrectomy with gastroenterostomy were performed. The duodenum was dealt with by means of a tube duodenostomy. There was no mortality among these patients. Morbidity was related mainly to the extent of preoperative bleeding and associated pathology (e.g. perforation). Patient data is presented in Table I.
Topics: Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Duodenal Ulcer; Duodenostomy; Enterostomy; Female; Gastrectomy; Humans; Male; Peptic Ulcer Hemorrhage; Pylorus; Vagotomy, Proximal Gastric
PubMed: 3251883
DOI: No ID Found -
The Turkish Journal of Gastroenterology... Dec 2020
Topics: Adult; Duodenostomy; Enteral Nutrition; Female; Humans; Intestinal Obstruction; Jejunal Diseases; Jejunal Neoplasms; Ovarian Neoplasms; Ultrasonography, Interventional
PubMed: 33626014
DOI: 10.5152/tjg.2020.2001 -
Zhonghua Wai Ke Za Zhi [Chinese Journal... Apr 1990Twenty patients underwent enlarged choledocho-duodenostomy in the treatment of bile duct residual stones, stones lodged in hepatobiliary ducts, muddy calculi or distal...
Twenty patients underwent enlarged choledocho-duodenostomy in the treatment of bile duct residual stones, stones lodged in hepatobiliary ducts, muddy calculi or distal stenosis of the common bile duct. Postoperative courses were all uneventful. Twenty one up to fourty one months follow-up found all patients well nourished and back to their original work. Postoperative duodenoscopy done in 17 cases found perianastomatic inflammation in 5, upper GI barium study revealed regurgitation in 4. B-model ultrasonography showed the extraction of residual stones. It is the author's belief that this procedure has the advantage of avoiding the "cul-de-sac" and bile stasis, hence preventing reflux and retrograde infection as well as its safety and easy performing.
Topics: Adolescent; Adult; Aged; Bile Ducts, Intrahepatic; Child; Choledochostomy; Cholelithiasis; Duodenostomy; Female; Humans; Male; Middle Aged
PubMed: 2379436
DOI: No ID Found -
El Dia Medico Apr 1959
Topics: Bile Ducts; Common Bile Duct; Duodenostomy; Humans
PubMed: 13663682
DOI: No ID Found -
Journal of Robotic Surgery Oct 2019Duodenal stenosis is one of the leading causes of duodenal obstruction in the pediatric population, usually diagnosed in newborns and in Down syndrome patients. It has...
Duodenal stenosis is one of the leading causes of duodenal obstruction in the pediatric population, usually diagnosed in newborns and in Down syndrome patients. It has historically been treated with duodeno-duodenostomy, an operation that is now commonly performed laparoscopically. We present a case of a 10-year-old child with a rare chromosomal abnormality who was diagnosed with a duodenal stricture after presenting with failure to thrive and inability to tolerate tube feeds. Duodeno-duodenostomy was performed using the da Vinci robot, allowing for improved intra-operative range of motion and control during anastomosis creation, with the same cosmetic benefits of laparoscopic surgery, and subsequent improvement in symptoms postoperatively. This case highlights the utility of robotic surgery in complex operations in the pediatric population.
Topics: Animals; Child; Duodenal Obstruction; Duodenostomy; Duodenum; Humans; Intestinal Atresia; Laparoscopy; Male; Pediatrics; Robotic Surgical Procedures; Treatment Outcome
PubMed: 30406381
DOI: 10.1007/s11701-018-0891-5 -
The Australian and New Zealand Journal... May 1995Three patients with bleeding duodenal ulcer underwent emergency Pólya's gastrectomy for haemostasis after failed endoscopic treatment. Intra-operatively, it was...
Three patients with bleeding duodenal ulcer underwent emergency Pólya's gastrectomy for haemostasis after failed endoscopic treatment. Intra-operatively, it was impossible to close the duodenal stump safely because of surrounding fibrosis and scarring. Controlled lateral wall duodenostomy was performed as an attempt to lower the intraluminal pressure of the afferent loop and good results had been observed in all three patients.
Topics: Duodenal Ulcer; Duodenostomy; Gastrectomy; Humans; Peptic Ulcer Hemorrhage
PubMed: 7741680
DOI: 10.1111/j.1445-2197.1995.tb00652.x -
AJR. American Journal of Roentgenology May 1988
Topics: Blind Loop Syndrome; Duodenostomy; Enterostomy; Humans; Palliative Care; Punctures
PubMed: 2451880
DOI: 10.2214/ajr.150.5.1199-a -
Pediatric Surgery International Feb 2017The surgical management of neonates with duodenal atresia (DA) involves re-establishment of intestinal continuity, either by duodeno-duodenostomy (DD) or by... (Comparative Study)
Comparative Study
PURPOSE
The surgical management of neonates with duodenal atresia (DA) involves re-establishment of intestinal continuity, either by duodeno-duodenostomy (DD) or by duodeno-jejunostomy (DJ). Although the majority of pediatric surgeons perform DD repair preferentially, we aimed to analyze the outcome of DA neonates treated with either surgical technique.
METHODS
Following ethical approval (REB:1000047737), we retrospectively reviewed the charts of all patients who underwent DA repair between 2004 and 2014. Patients with associated esophageal/intestinal atresias and/or anorectal malformations were excluded. Outcome measures included demographics (gender, gestational age, and birth weight), length of mechanical ventilation, time to first and full feed, length of hospital admission, weight at discharge (z-scores), and postoperative complications (anastomotic stricture/leak, adhesive obstruction, and need for re-laparotomy). Both DD and DJ groups were compared using parametric or non-parametric tests, with data presented as mean ± SD or median (interquartile range).
RESULTS
During the study period, 92 neonates met the inclusion criteria. Of these, 47 (51%) had DD and 45 (49%) DJ repair. All procedures were performed open, apart from one laparoscopic DJ. Overall, DD and DJ groups had similar demographics. Likewise, we found no differences between the two groups for length of ventilation (p = 0.6), time to first feed (p = 0.5), time to full feed (p = 0.4), length of admission (p = 0.6), prokinetic use (p = 0.5), nor weight at discharge (p = 0.1). When the 30/92 (33%) patients with trisomy-21 (DD = 16, DJ = 14) were excluded from analysis, the groups still had similar weight at discharge (p = 0.2). Postoperative complication rate was not different between the two groups. One patient per group died, due to respiratory failure (DD) and sepsis (DJ).
CONCLUSIONS
This study demonstrates that in neonates with duodenal atresia, duodeno-duodenostomy and duodeno-jejunostomy have similar outcomes. These findings are relevant for surgeons who repair duodenal atresia laparoscopically, as duodeno-jejunostomy had equal clinical outcomes and may be easier to perform.
Topics: Duodenal Obstruction; Duodenostomy; Duodenum; Female; Humans; Infant, Newborn; Intestinal Atresia; Jejunostomy; Male; Retrospective Studies; Treatment Outcome
PubMed: 27858187
DOI: 10.1007/s00383-016-4016-9