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  • Title: [Congenital duodenal obstruction: comparison of two corrective methods].
    Author: Baeza-Herrera C, Salinas-Montes J, Salinas-Montes G, Montero-Uscanga CA, López-Castellanos J.
    Journal: Rev Gastroenterol Mex; 2009; 74(1):1-5. PubMed ID: 19666312.
    Abstract:
    INTRODUCTION: There are few studies on congenital duodenal obstruction. The poor peristalsis of the proximal duodenum that causes functional obstruction is a well known problem that occurs in the immediate postoperative period. The optimum technique to address the problem is still controversial. OBJECTIVE: To compare the results obtained using two different surgical techniques to resolve congenital duodenal obstruction. PATIENTS AND METHODS: A five-year retrospective review of the neonates who underwent surgery for duodenal obstruction was undertaken. Two different surgical techniques were used: the Kimura operation and Heinecke-Mikulicz enteroplasty. The clinical characteristics, operative time, onset of oral feeding, hospital stay, complications and mortality were analyzed. The results of both groups were compared. RESULTS: Forty-one patients were included; 27 were operated on with the Kimura technique and 14 underwent Heinecke-Mikulicz duodenoplasty.Thirty-five patients had duodenal atresia (86%) and 6 (14%) an annular pancreas. All of them had post-Vater's papilla obstruction and 8 (20%) had trisomy 21. The clinical characteristics of both groups were similar. No significant difference was found in the operative time, onset of oral feeding and hospital stay. Eight patients in each group developed septicemia (30% in the Kimura group vs. 57% in the Heinecke-Mikulicz group, p = 0.16) and one patient in each group died (4% in the Kimura group vs.7% in the Heinecke-Mikulicz group, p = 0.78). CONCLUSION: The Kimura duodenal-duodenal anastomosis and Heinecke-Mikulicz duodenoplasty seem to be useful procedures to resolve congenital duodenal obstruction.
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