Kellie L Mathis1, David R Farley. 1. Department of Surgery, Mayo Clinic College of Medicine, 200 First St. S.W., Rochester, MN 55905, USA.
Abstract
BACKGROUND: Duodenal diverticula are common but rarely cause symptoms that require operative intervention. METHODS: The charts of 34 patients who underwent a laparotomy at a single institution for complications of a duodenal diverticulum between the years of 1969 and 2001 were reviewed. RESULTS: The indications for operation included perforation (n = 10), gastrointestinal bleeding (7), intractable pain (6), biliary or pancreatic obstruction (4), gastrointestinal obstruction (2), steatorrhea (2), questionable malignancy (2), and cholecystodiverticular fistula (1). The operation consisted of diverticulectomy in 27 patients, duodenal resection in 4, diverticular inversion in 2, and a controlled duodenal fistula in 1. An additional drainage procedure was performed in 7 patients. Perioperative mortality rate was 3%. Early (15%) and late (12%) morbidity rates were significant. CONCLUSIONS: Operative treatment of duodenal diverticula is safe but should be reserved for those with emergent presentations or intractable symptoms.
BACKGROUND: Duodenal diverticula are common but rarely cause symptoms that require operative intervention. METHODS: The charts of 34 patients who underwent a laparotomy at a single institution for complications of a duodenal diverticulum between the years of 1969 and 2001 were reviewed. RESULTS: The indications for operation included perforation (n = 10), gastrointestinal bleeding (7), intractable pain (6), biliary or pancreatic obstruction (4), gastrointestinal obstruction (2), steatorrhea (2), questionable malignancy (2), and cholecystodiverticular fistula (1). The operation consisted of diverticulectomy in 27 patients, duodenal resection in 4, diverticular inversion in 2, and a controlled duodenal fistula in 1. An additional drainage procedure was performed in 7 patients. Perioperative mortality rate was 3%. Early (15%) and late (12%) morbidity rates were significant. CONCLUSIONS: Operative treatment of duodenal diverticula is safe but should be reserved for those with emergent presentations or intractable symptoms.
Authors: Yu Jin Kwon; Ji Hun Kim; Seung Hyoung Kim; Bong Soo Kim; Heung Up Kim; Eun Kwang Choi; In Ho Jeong Journal: World J Gastroenterol Date: 2009-08-14 Impact factor: 5.742