title: Laparoscopic simple oblique duodenoduodenostomy in management of congenital duodenal obstruction in children.
abstract: BACKGROUND
  The aim of this report is to present our technique of laparoscopic simple oblique duodenoduodenostomy (LSOD) and its results in management of congenital duodenal obstruction (CDO) in children.
  
  
  METHODS
  Medical records of patients with the diagnosis of CDO undergoing LSOD at our center from March 2009 to December 2013 were reviewed. The LSOD used one infra- or transumbilical 5-mm port for the camera and two 3-mm ports for instruments. After mobilization of the distant part of the duodenum, a 5-0 polydioxanone seromuscular suture was placed on the duodenal wall proximal and distal to the obstruction and tacked to the anterior abdominal wall for traction. The lower duodenum was incised longitudinally distal to the traction suture. The upper duodenum incision was placed away from the traction suture and extended downward obliquely. The duodenoduodenostomy was performed as a "simple" anastomosis.
  
  
  RESULTS
  Forty-eight patients were identified with a median age at operation of 11 days. The median weight at operation was 2650 g. Duodenal atresia and annular pancreas were found in 81.2% and 18.8% of patients, respectively. The median operative time was 90 minutes. There was no conversion to open surgery, anastomotic leakage, or stenosis. The median time from the operation to initial oral feeding was 4 days. Of the 48 patients, 97.9% were discharged in good health with a median postoperative hospital stay of 7 days
  
  
  CONCLUSIONS
  The LSOD technique is safe and efficacious and can be a viable option in the management of select cases of CDO in children at experienced centers.
authors.affiliation: Surgical Department, National Hospital of Pediatrics , Hanoi, Vietnam .
authors.forename: Tran Ngoc
authors.initials: TN
authors.lastname: Son
authors.forename: Nguyen Thanh
authors.initials: NT
authors.lastname: Liem
authors.forename: Hoang Huu
authors.initials: HH
authors.lastname: Kien
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D002675:Child, Preschool; D061887:Conversion to Open Surgery; D004065:Digestive System Abnormalities / Q000601:surgery; D004380:Duodenal Obstruction / Q000150:complications / Q000209:etiology / Q000601:surgery*; D004385:Duodenostomy / Q000379:methods*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007409:Intestinal Atresia; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D010179:Pancreas / Q000002:abnormalities* / Q000601:surgery; D010182:Pancreatic Diseases / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D013537:Sutures