Triangular tapered duodenoplasty for the treatment of congenital duodenal obstruction

• Published in: Journal of pediatric surgery 2002-06, Vol.37 (6), p.862-864
• Main Authors: Alexander, Frederick, DiFiore, John, Stallion, Anthony
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; congenital duodenal obstruction; Digestive System Surgical Procedures - methods; Digestive System Surgical Procedures - mortality; Duodenal Obstruction - congenital; Duodenal Obstruction - surgery; Duodenoplasty; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Infant, Newborn; Length of Stay; Male; Medical sciences; Other diseases. Semiology; Postoperative Care; Stomach, duodenum, intestine, rectum, anus; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Rate
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1053/jpsu.2002.32888

Background/Purpose: To evaluate the safety and efficiency of triangular tapered duodenoplasty, a modified procedure for the treatment of congenital duodenal obstruction was designed. Methods: Eight children underwent triangular tapered duodenoplasty over a 5-year period with a minimum follow-up of 27-months. Study parameters include morbidity and mortality postsurgical time to feedings, hospital length of stay, and weight gain. In addition, all patients were asked to undergo postoperative gastric emptying scans and upper gastrointestinal series (UGIS). Results: Eight children underwent triangular tapered duodenoplasty with 0% surgical morbidity and mortality rates. Mean postsurgical time to feedmap was 5.7 days (range, 2 to 12 days), and mean hospital length of stay was 9.6 days (range, 4 to 15 days). Mean NCHS weight gain was 50% (range, 25% to 75%). Five patients underwent postoperative gastric emptying scans with a mean Tc 43 minutes (range, 24 to 70 minutes; normal, 50 minutes). Four patients underwent postoperative UGIS showing no evidence of megaduodenum in any patient. Conclusions: Triangular tapered duodenoplasty is safe and effective in the treatment of congenital duodenal obstruction. The morbidity and mortality rates and hospital stay resulting from this procedure are the lowest as yet reported in the medical literature. J Pediatr Surg 37:862-864. Copyright 2002, Elsevier Science (USA). All rights reserved.