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  • Title: Complete laparoscopic duodenojejunostomy for superior mesenteric artery syndrome: Linear stapled closure of the common enterotomy.
    Author: Yoneda A, Kanetaka K, Yamaguchi S, Koga Y, Isagawa Y, Maruya Y, Inoue Y, Torashima Y, Adachi T, Hidaka M, Kobayashi K, Ito S, Eguchi S.
    Journal: Asian J Endosc Surg; 2020 Oct; 13(4):552-555. PubMed ID: 31845494.
    Abstract:
    Superior mesenteric artery syndrome can lead to duodenal obstruction due to vascular compression. We treated a patient with superior mesenteric artery syndrome by performing a complete laparoscopic duodenojejunostomy with a linear stapled closure of the common enterotomy. A 72-year-old woman presented with nausea, vomiting, and weight loss. CT revealed superior mesenteric artery syndrome. Conservative management was not effective. Because the patient required a surgical bypass for long-term relief, a laparoscopic duodenojejunostomy was performed. In past cases, hand-sewn sutures were made through a small incision to avoid stenosis when the common enterotomy was closed. For our patient, we closed the common enterotomy with a linear stapler in a complete laparoscopic maneuver. We performed the closure after placing several temporary sutures to minimize the amount of intestinal wall to be removed. Laparoscopic duodenojejunostomy is a minimally invasive procedure, and a linear stapled closure of a common enterotomy is a safe surgical technique that reduces invasiveness.
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