PURPOSE: The aim of this study was to evaluate the role of laparoscopy in the surgical treatment of intrinsic and extrinsic duodenal lesions referring to the underlying cause of obstruction. METHODS: Retrospective chart review of all cases of duodenal obstructions undergoing surgery at our institution between April 2004 and March 2012. RESULTS: Twenty patients underwent surgery for duodenal obstruction (11 female, 9 male). Seven infants were born prematurely. Eleven infants had extrinsic, seven had intrinsic and two had a combination of intrinsic and extrinsic duodenal lesions. A laparoscopic procedure was initially started in 18 of 20 patients (90 %). Thirteen of the 18 infants (72 %) underwent various laparoscopic procedures: laparoscopic duodenoduodenostomy, resection of a duodenal membrane and the transsection of Ladd's bands. In five patents, a conversion became necessary due to poor visualisation of the duodenum. In three patients (15 %) with extrinsic duodenal lesion a reoperation was necessary. Two of the 20 patients (10 %) were operated with an "open" approach to begin with. CONCLUSION: Laparoscopy is feasible and safe in most cases. The few conversions were early in the series due to a lack of experience and necessitated by poor visualisation, most often caused by malrotation.
PURPOSE: The aim of this study was to evaluate the role of laparoscopy in the surgical treatment of intrinsic and extrinsic duodenal lesions referring to the underlying cause of obstruction. METHODS: Retrospective chart review of all cases of duodenal obstructions undergoing surgery at our institution between April 2004 and March 2012. RESULTS: Twenty patients underwent surgery for duodenal obstruction (11 female, 9 male). Seven infants were born prematurely. Eleven infants had extrinsic, seven had intrinsic and two had a combination of intrinsic and extrinsic duodenal lesions. A laparoscopic procedure was initially started in 18 of 20 patients (90 %). Thirteen of the 18 infants (72 %) underwent various laparoscopic procedures: laparoscopic duodenoduodenostomy, resection of a duodenal membrane and the transsection of Ladd's bands. In five patents, a conversion became necessary due to poor visualisation of the duodenum. In three patients (15 %) with extrinsic duodenal lesion a reoperation was necessary. Two of the 20 patients (10 %) were operated with an "open" approach to begin with. CONCLUSION: Laparoscopy is feasible and safe in most cases. The few conversions were early in the series due to a lack of experience and necessitated by poor visualisation, most often caused by malrotation.
Authors: Patricia A Valusek; Troy L Spilde; KuoJen Tsao; Shawn D St Peter; George W Holcomb; Daniel J Ostlie Journal: Surg Endosc Date: 2007-02-16 Impact factor: 4.584
Authors: Troy L Spilde; Shawn D St Peter; Scott J Keckler; George W Holcomb; Charles L Snyder; Daniel J Ostlie Journal: J Pediatr Surg Date: 2008-06 Impact factor: 2.545
Authors: Aaron R Jensen; Scott S Short; Dean M Anselmo; Manuel B Torres; Philip K Frykman; Cathy E Shin; Kasper Wang; Nam X Nguyen Journal: J Laparoendosc Adv Surg Tech A Date: 2013-10 Impact factor: 1.878