The tests on gastric acid of patients with the perforated duodenal ulceration operated in ViÖt §øc Hospital were carried out and compared with these of patients who received an operation of the duodenal ulceration perforation by traditional method. The results have shown that the Taylor method has a reduction of gastric acid as the basic test and the insulin test were 41% and 49%, resectively. The Hill Barker method has a reduction of gastric acid as 2 above mentioned tests were 56% and 64%, respectively. The reduction of gastric acid as the Hill Barker method was a statistical significant different from this as the Taylor method (P=0.0022). The reduction of gastric acid in 2 above methods was stable (P=0.05). There were serious complications for patients in tests.
duodenal ulcer ; Duodenal Diseases ; surgery

After 598 cases of ulcerated duodenal two- thirds gastrectomy as Billroth II, The authors came to the following conclusion: (1) Gastrectomy for duodenal ulcer covered 38% (598/1573): male 88.3%; female 41.7%. The average time of getting the disease was from 6 to 15 years (46.5%). The main age was from 31 to 50 (61.04%). The therapeutic state before operation was limited; appointing the operation in turn was 99.66%; emergency operation was 1.34%. (2). The mortality of 0.33%; complication 2.1% (spleen cutting, joining bleeding; stump duodenal fistula...) were generally low. This result was achieved by operative decisions in which the majority was operation in turns. (3) The long-term results were quite good that we could see in many tests, Ranked following Visick 1948, we saw VI: 60.6%; VII: 31.31%; VIII: 6.06%; IX: 2.02%.
duodenal ulcer ; Duodenal Diseases ; surgery ; therapeutics

75 patients (male: 9) with ages of 15-60 and duodenal ulceration had no effect with the drug therapy during 10/1990-10/1995 received the selective proximal gastric vagotomy. The preoperative, intraoperative and postoperative gastric pH was measured by grassy method. The result has shown that the preoperative pH was 1.2-3.2, the postoperative pH of selective proximal vagotomy (nerve cord for acid secretion) was 5.5-6.4. pH in the gastric antrum beyond the big curve which is far from pylorus about 5 cm was less 1.5.
duodenal ulcer ; Duodenal Diseases ; surgery ; therapeutics

A restrospective study on 484 patients with the perforated duodenal ulceration has shown that male/female:9/1, patients with ages of 20 -50: 77% (youngest: 14; oldest: 80), no history of the duodenal ulceration: 33.34%, operated prior to 12 hours from the first pain attack, premature ulceration: 24%, moderate fibrosis: 14%, corn fibrosis: 62%, possitive clotest: 83%, simple surgical: 70%, mortality rate: 1.5%, rupture in stitching position in the method of stitching the perforated position, relapsed rate of ulceration in the stitching the perforation position and removal surgery of 2/3 stomach, Xth nervecutting as method of TALOR and method of HILL-BARKER were 72%, 3.5%, 34% and 8%, respectively. This study indicated that it should radically operate in the first phase in order to reduce the patient‘s risk provided that having no risk factors.
duodenal ulcer ; Duodenal Diseases ; therapeutics ; surgery

Background: Duodenal fistula is severe complication and complicated in management. Morbidity and mortality were high. The aims of study were to determine the clinical characteristic of duodenal fistula after surgical treatment of duodenal blunt and penetrating trauma, and attitude of treatment. Methodology: Retrospective study was done. Data of the patients with post-operative duodenal fistula after surgical procedure who were admitted in Cho Ray Hospital from 6-1996 to 6-2000 were analyzed. Results: There were 15 posttraumatic duodenal fistulas. Locations of fistula were often in D2 and D3 (80% of cases). Time of appearance of fistula was 10,257,25 days (2-29 days) after operative management of duodenal trauma. Mean of fistula output was 573626ml/24 hours. Total of energy of parenteral nutrition was 800130,23 Kcalo. Post-operative mortality was 26%. Only one case or 6.7% was spontaneous closure with medical treatment. 67.3% of cases was healed by surgical treatment. Conclusion: Main treatment for post-operative fistula of duodenal trauma is surgical procedure. Need of selection of appropriate time for operation is proposed. Pre- and post-operative management such as withholding oral taking, replacing fluid and electrolytes, and administering total parenteral should be paid attention
Duodenal Diseases ; Wounds and Injuries ; surgery

Cannula ; Catheters ; Drainage ; Duodenal Diseases ; Humans ; Intestinal Fistula/surgery*

OBJECTIVETo assess the clinical value of endoscopic submucosal dissection(ESD) for duodenal lesion.

METHODSA total of 78 patients with duodenal lesion were treated with ESD from November 2006 to August 2010. The clinical data were retrospectively analyzed.

RESULTSThere were 46 male and 14 female patients. The mean age was(54±9) years. The lesion location included the duodenal bulb(n=39, 50%), the junction of bulb and descending part(n=19, 24.4%), and the descending part(n=20, 25.8%). The mean diameter of the lesions was(2.1±1.7) cm. Fifty-one(65.4%) lesions originated from the mucosa, including inflammatory/ hyperplastic polyps(n=22, 28.2%), villous/tubular adenoma(n=26, 33.3%), and hamartomas polyps(n=3, 3.8%). Twenty-five(32.1%) lesions originated from the submucosa, including Brunner's glands adenoma(n=15, 19.2%), ectopic pancreas(n=3, 3.8%), carcinoid tumor(n=3, 3.8%), lipoma(n=2, 2.6%), myxoinoma(n=1, 1.3%), and angio-lymphangioma(n=1, 1.3%). There were two lesions originated from the muscularis propria(n=2, 2.5%), and both were ectopic pancreas. All cases received ESD successfully. The mean operative time was(37±41) min and the mean blood loss was(23±15) ml. The perioperative complication rate was 35.9%(28/78), including intraoperative perforation(n=6), delayed perforation(n=3), intraoperative hemorrhage(n=10), delayed bleeding(n=7), and transient elevation of serum amylase(n=2). Postoperative pathological examination showed vascular invasion with tumor cells in one patient, who received extended resection later. The remaining 77 patients showed no recurrence during the followed up(rang, 3-23 months) using endoscopy.

CONCLUSIONESD is an effective, safe, minimally invasive method for the management of duodenal lesions.

Adult ; Aged ; Duodenal Diseases ; surgery ; Female ; Follow-Up Studies ; Gastroscopy ; methods ; Humans ; Intestinal Mucosa ; surgery ; Male ; Middle Aged ; Retrospective Studies

No abstract available.
Adult ; Biopsy ; *Brunner Glands/pathology/surgery ; Duodenal Diseases/*complications/diagnosis/surgery ; Duodenal Obstruction/diagnosis/*etiology/surgery ; Duodenoscopy ; Gastric Outlet Obstruction/diagnosis/*etiology/surgery ; Hamartoma/*complications/diagnosis/surgery ; Humans ; Male ; Tomography, X-Ray Computed ; Treatment Outcome

Duodenal diverticula are common, but perforated duodenal diverticulum is rare. Because of the disease rarity, there is no standard management protocol for perforated duodenal diverticulum. To properly manage this rare complication, a clear preoperative diagnosis and clinical disease severity assessment are important. An abdomino-pelvic CT is an unquestionably crucial diagnostic tool. Perforation is considered a surgical emergency, although conservative treatment based on fasting and broad-spectrum antibiotics may be offered in some selected cases. Herein, we report two cases of perforated duodenal diverticulum, one case managed with surgical treatment and one with conservative treatment.
Aged ; Diverticulum/complications/*diagnosis/surgery ; Duodenal Diseases/complications/*diagnosis/surgery ; Endoscopy, Digestive System ; Humans ; Intestinal Perforation/*diagnosis/etiology/surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVE: To analyze clinical manifestations, diagnosis and treatment of annular pancreas in neonates. METHODS: Clinical data of 114 neonates with annular pancreas admitted in the Children's Hospital of Zhejiang University from January 2009 to December 2018 were reviewed. The demographic parameters (gestational age, birth weight), clinical manifestations, onset time, results of antenatal examination, associated anomalies, radiological findings, operations, postoperative complications were analyzed. RESULTS: One hundred and two cases were examined by abdominal echography, in which 68 cases showed duodenal obstruction, 4 cases showed annular pancreas. Plain abdomen X-ray examination performed in 113 cases before operation, 76 cases presented double-bubble sign, 12 cases presented single-bubble sign and 5 cases had high-position intestinal obstruction. Upper gastrointestinal radiography (UGI) was performed in 103 cases, which suggested duodenal obstruction in 102 cases. Operations were performed in all cases, of which 69 cases were operated under laparoscopy including 1 case converted to open laparotomy. The mean fasting time after surgery was (7.8±2.7) d, and the mean length of hospital stay was (16.9±10.1) d. Five patients had postoperative complications. The incidence of postoperative complications in antenatal abnormal group was lower than that in the antenatal non-abnormal group (<0.05); the average fasting time in laparoendscopic surgery group was shorter than that in traditional laparotomy group (<0.05). CONCLUSIONS Neonates with recurrent vomiting early after birth should be highly suspected to have annular pancreas. The fetal chromosome examination should be performed with abnormal antenatal screening. Surgery is the only effective way to diagnose and treat annular pancreas, and laparoscopic surgery could be the first choice for experienced doctors.
Duodenal Obstruction ; diagnostic imaging ; surgery ; Humans ; Infant, Newborn ; Laparoscopy ; Pancreas ; abnormalities ; diagnostic imaging ; pathology ; surgery ; Pancreatic Diseases ; diagnostic imaging ; pathology ; surgery ; Retrospective Studies