Duodenal lengthening in short bowel with dilated duodenum

Journal of Pediatric Surgery
J BuenoOscar Segarra

Abstract

Although duodenal dilatation occurs in children with short bowel syndrome (SBS) facilitating dismotility and bacterial overgrowth, the duodenum has been an untouchable intestinal segment for lengthening procedures owing to its close relationship with bilio-pancreatic structures and blood supply shared with the pancreas. Three children (age range, 0.5-7 years) with SBS and dilated duodenum underwent a novel surgical procedure of duodenal lengthening combined with a technical modification of serial transverse enteroplasty (STEP). Pre-STEP, jejunum length was 5, 35 and 45cm, respectively. Duodenal lengthening was performed with sequential transverse applications of an endoscopic stapler on the anterior and posterior wall of the duodenum to avoid bilio-pancreatic structure injury. Two patients underwent 3 duodenal firings (stapler of 35mm) and the third 5 firings (stapler of 45mm). Duodenal firings were 17%, 21% and 83% of the total firings. No surgical complications occurred. One patient developed transient episodes of D-lactic acidosis. Two patients (5 and 45cm) were weaned off parenteral nutrition at 12months post-surgery and the remaining patient´s (35cm) parenteral calorie requirements have decreased by 60%. Duodenal lengtheni...Continue Reading

References

Jun 5, 2003·Journal of Pediatric Surgery·Heung Bae KimTom Jaksic
Jan 18, 2006·Journal of Pediatric Surgery·Sonya R WalkerEdward M Barksdale
Sep 7, 2006·Journal of Pediatric Gastroenterology and Nutrition·Biren P ModiTom Jaksic
Nov 4, 2008·Journal of Pediatric Gastroenterology and Nutrition·K ReinshagenK L Waag
May 13, 2009·Journal of Pediatric Surgery·Y Avery ChingHeung Bae Kim
May 19, 2012·Journal of Pediatric Surgery·Carol OliveiraPaul W Wales
Jan 30, 2013·Journal of the American College of Surgeons·Brian A JonesUNKNOWN International STEP Data Registry
Mar 19, 2013·American Journal of Surgery·Patrick J JavidPatrick J Healey

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Citations

Apr 19, 2016·Best Practice & Research. Clinical Gastroenterology·Matthijs J HommelJan Willem Haveman
Jul 28, 2016·Pediatric Surgery International·Melissa A FernandesLan Vu
Oct 6, 2016·Indian Journal of Pediatrics·Theodoric Wong, Girish Gupte
Oct 30, 2018·World Journal of Transplantation·Ignazio R Marino, Augusto Lauro
Nov 7, 2017·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Javier BuenoJoaquin Balsells
Feb 23, 2019·Expert Review of Gastroenterology & Hepatology·Augusto Lauro, Florence Lacaille
Jan 1, 2017·Pediatric Surgery International·Michael E Höllwarth
Mar 16, 2018·Pediatric Surgery International·Daniele AlbertiGiovanni Boroni
Mar 5, 2021·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Sjoerd C J NagelkerkeR Bakx
Sep 18, 2021·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Javier BuenoManuel López

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