Triangular tapered duodenoplasty for the treatment of congenital duodenal obstruction.
OBJECTIVE
To evaluate the safety and efficiency of triangular tapered duodenoplasty, a modified procedure for the treatment of congenital duodenal obstruction was designed.


METHODS
Eight children underwent triangular tapered duodenoplasty over a 5-year period with a minimum follow-up of 27-months. Study parameters include morbidity and mortality postsurgical time to feedings, hospital length of stay, and weight gain. In addition, all patients were asked to undergo postoperative gastric emptying scans and upper gastrointestinal series (UGIS).


RESULTS
Eight children underwent triangular tapered duodenoplasty with 0% surgical morbidity and mortality rates. Mean postsurgical time to feedmap was 5.7 days (range, 2 to 12 days), and mean hospital length of stay was 9.6 days (range, 4 to 15 days). Mean NCHS weight gain was 50% (range, 25% to 75%). Five patients underwent postoperative gastric emptying scans with a mean Tc 43 minutes (range, 24 to 70 minutes; normal, 50 minutes). Four patients underwent postoperative UGIS showing no evidence of megaduodenum in any patient.


CONCLUSIONS
Triangular tapered duodenoplasty is safe and effective in the treatment of congenital duodenal obstruction. The morbidity and mortality rates and hospital stay resulting from this procedure are the lowest as yet reported in the medical literature.
Alexander
Frederick
F
Department of Pediatric Surgery, The Cleveland Clinic Foundation, The Cleveland Clinic Children's Hospital, Cleveland, OH, USA.
Difiore
John
J
Stallion
Anthony
A
D013505:Digestive System Surgical Procedures / Q000379:methods* / Q000401:mortality; D004380:Duodenal Obstruction / Q000151:congenital* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D011182:Postoperative Care; D015996:Survival Rate