%0 Journal Article
%T Gastroduodeno-plasty performed by distal gastric transection.- A new technique for large duodenal defect closure
%A B¨šsing Martin
%A Shaheen Hassan
%A Riege Raute
%A Utech Markus
%J Annals of Surgical Innovation and Research
%D 2012
%I BioMed Central
%R 10.1186/1750-1164-6-6
%X Introduction Duodenal ulcer lesions can represent a surgical challenge, especially if the duodenal wall is chronically inflamed, the defect exceeds a diameter of 3 cm and the ulceration is located in the second part of the duodenum. Patient and method We present the case of a 70-year-old male, who suffered from a 3 x 4 cm duodenal defect caused by duodenal pressure necrosis due to a 12.5 x 5.5 x 5 cm gallstone. Additionally, this stone caused intestinal obstruction (BouveretĄ¯s syndrome) and bleeding with signs of shock. Besides the gallstone extraction, the common bile duct was drained by a T-tube and the duodenal defect closure was performed by a gastroduodeno-plasty and Bilroth II gastroenterostomy. The postoperative phase was uneventful. The reconstructed duodenum was endoscopically accessible and showed no pathological findings on follow-up. Conclusion The reconstruction of a large defect (> 3 cm) of the second part of the duodenum is safely feasible by a gastroduodeno-plasty. The critical gastroduodenal anastomosis can be protected by duodenal decompression, achieved by placing a T-tube in the common bile duct.
%K Duodenal defect
%K BouveretĄ¯s syndrome
%K Gastroduodeno-plasty
%U http://www.asir-journal.com/content/6/1/6