Lesions which originate from or invade distal duodenum, 3rd and 4th segments of duodenum, are commonly tricky and the surgical treatment of them are full of challenges.
Researchers have found in a new study that E-style duodenojejunostomy for the reconstruction of distal duodenum resection is safe and feasible. Further the E-style duodenojejunostomy avoids a blind pouch and prevents the development of blind pouch syndrome.
Distal duodenal resections are sometimes necessary for radical surgery, but how to restore duodenal continuity is still unclear. This study aimed at determining which style of anastomosis was more suitable for the duodenojejunostomy after resection of distal duodenum.
They retrospectively identified 34 patients who underwent distal duodenum resection at our center between January 2014 and December 2021. According to whether the end or the side of the proximal duodenum was involved in reconstruction, duodenojejunostomy were classified as End style (E-style) and Side style (S-style). Demographic data, clinicopathological details, and postoperative complications were analyzed between two groups. Results:
• Thirteen patients (38.2%) received E-style duodenojejunostomy, and 21 patients (62.8%) received S-style duodenojejunostomy.
• Comparative analysis showed that in group of E-style, patients had a lower rate of multivisceral resection, delayed gastric emptying (DGE) and intraperitoneal infection
• In this study, the incidence of major complications was up to 35.3% (12/34) and no patient died of complication in perioperative period. • In two group, there was no difference in the incidence of major complications
The E-style duodenojejunostomy for the reconstruction of distal duodenum resection is safe and feasible. The E-style anastomosis may have potential value in decreasing the occurrence of complications such as DGE and intraperitoneal infection, and the definitive advantages still need to be verified.
Reference:
Liu, W., Wang, J., Ma, L. et al. Which style of duodenojejunostomy is better after resection of distal duodenum. BMC Surg 22, 409 (2022). https://doi.org/10.1186/s12893-022-01850-2
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