title: Laparoscopic duodenal-jejunal bypass for the treatment of duodenal obstruction caused by annular pancreas: description of a surgical technique.
abstract: Annular pancreas is a rare congenital anomaly, which is only surgically treated in symptomatic cases. Surgical treatment consists of bypassing the duodenal transit by gastrojejunal or duodenal-jejunal anastomosis. In the absolute majority of published cases, laparotomy is the most widely used access technique. The aim of this article is to report a case of an annular pancreas and describe the technical steps involved in carrying out a laparoscopic duodenal-jejunal anastomosis, for correction of the duodenal obstruction. The patient's recovery was uneventful; she was discharged on the fourth postoperative day and remained asymptomatic for the 2-year, outpatient follow-up period. Laparoscopic duodenal-jejunal bypass is shown to be feasible and safe, and produce less surgical trauma, when carried out by an experienced surgeon who is duly trained and familiar with the laparoscopic technique.
authors.affiliation: Gastric Surgery Division, Department of Gastroenterology, Digestive Surgery, University of São Paulo School of Medicine, SP, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Zilberstein
authors.forename: Mauricio P
authors.initials: MP
authors.lastname: Sorbello
authors.forename: Ivan R B
authors.initials: IR
authors.lastname: Orso
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D004380:Duodenal Obstruction / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010179:Pancreas / Q000002:abnormalities / Q000473:pathology; D010182:Pancreatic Diseases / Q000473:pathology; D055815:Young Adult