Open AccessA MODIFIED TECHNIQUE FOR SURGICAL REMOVAL OF THE CONGENITAL DUODENAL OBSTRUCTION
Author(s) -
Mikhail Chepurnoy,
Gennady Chepurnoy,
V. B. Katsupeev,
A. V. Leyga,
Ya. I. Chilibiyskiy,
Б Г Розин
Publication year - 2019
Publication title -
detskaâ hirurgiâ
Language(s) - English
Resource type - Journals
eISSN - 2412-0677
pISSN - 1560-9510
DOI - 10.18821/1560-9510-2019-23-3-146-149
Subject(s) - duodenum , jejunum , medicine , anastomosis , ligament , surgery
Purpose. To improve the duodenum function after Kimura surgery which is performed for the congenital duodenal obstruction by restoring the horseshoe-shaped duodenum. Material and methods. A comparative analysis of two groups of patients was made: In Group 1 (n = 31) , patients were operated with the mobilization of lower horizontal duodenal branch and duodenoduodenal anastomosis by Kimura without restoring the horseshoe-shape of the duodenum. In Group 2 (n = 11), children had similar surgeries but the horseshoe-shaped configuration of the duodenum was restored by fixing the initial part of the jejunum to the Treitz ligament. After surgery, the researchers radiographically compared time of barium suspension passage through the duodenum in patients of both groups. Results. In children from Group 1, passage of the contrast suspension via duodenum lasted for 43.9 ± 3.9 sec., what is approximately 2 times faster than in the norm. In patients from Group 2, this indicator was 3-4 times larger than in patients from Group 1 and was 158.2 ± 18.2 sec. Such a slowdown in the chyme passage along the duodenum prolongs exposure of food masses to pancreatic juice, bile and intestinal juice and, consequently, improves the duodenal function. Conclusion. The authors recommend to end the surgical intervention for eliminating congenital duodenal obstruction by Kimura technique with the restoration of horseshoe-shaped duodenum by fixing the initial part of the jejunum to the Treitz ligament.