Effect of laparoscopic simple oblique duodenoduodenostomy in the treatment of congenital duodenal obstruction in neonates
10.3760/cma.j.issn.1008-6706.2020.22.003
- VernacularTitle:腹腔镜下十二指肠简化斜形侧侧吻合术治疗新生儿十二指肠梗阻疗效观察
- Author:
Bing LI
1
;
Weibing CHEN
;
Shunlin XIA
;
Fengnian ZHANG
;
Xiaoting HU
;
Yongchun DU
;
Xiaomin WANG
Author Information
1. 江苏省，淮安市妇女儿童医院小儿外科 223002
- From:
Chinese Journal of Primary Medicine and Pharmacy
2020;27(22):2698-2702
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the possibility of laparoscopic simple oblique duodenoduodenostomy in the management of congenital duodenal obstruction in neonates.Methods:The clinical data of neonates with congenital duodenal obstruction undergoing laparoscopic simple oblique duodenoduodenostomy at Huaian Women and Children′s Hospital from February 2015 to February 2018 were retrospectively reviewed.By a lower-pressure pneumoperitoneum of 5-8mmHg and a suspending suture for right liver elevator, the procedure was performed using 4 ports: a transumbilical 5-mm port for the camera and another three 3-mm ports for instruments.After kocherizing of the proximal and distant part of the duodenum, the lower duodenum was incised longitudinally 0.5-1cm distal to the blocked end, the upper duodenum incision was placed 0.5cm away from the blocked end extended downward obliquely.The duodenoduodenostomy was performed as a " simple" " oblique" anastomosis with 5-0 PDS suture.Results:Fifteen patients were identified with a median age at operation of 2 days.Of all the cases, 4 cases were duodenal atresia (type Ⅲ), 11 cases were annular pancreas, and 7 cases of them were annular pancreas complicated with congenital intestinal malrotation.All cases were treated with laparoscopic simple oblique duodenoduodenostomy.Ladd procedure was accomplished in 7 cases with congenital intestinal malrotation in the meantime.The average operative time was (115.0±25.5) min (70-145 min). Feedings were started on postoperative 4-10d (mean 6.0d), without abdominal distention and vomit, all patients were discharged in good health with a median postoperative hospital stay of 7-14d(mean 10.6d). There was no mortality rate, no conversion to laparotomy, and no intraopertive complications in the group.The cases were followed-up for 2-36 months (mean 15.6 months), and all cases were doing well.Conclusion:Laparoscopic simple oblique duodenoduodenostomy is safe and efficacious in neonatal period, and can be a viable option in the treatment of neonates with congenital duodenal obstruction.
