The end-style duodenojejunostomy is safe for the reconstruction of distal duodenum resection and may decrease the occurrence of complications such as delayed gastric emptying and intraperitoneal infections in patients with gastrointestinal stromal tumors (GISTs), according to a new study published in the journal BMC Surgery.

However, the “definitive advantages [of the technique] still need to be verified,” the study authors noted.

To assess which style of anastomosis is better for duodenojejunostomy after the resection of the distal duodenum, a team of researchers from China led by Hanxing Tong from the Department of General Surgery at Zhongshan Hospital, Fudan University, in Shanghai conducted a retrospective study in 34 patients who underwent distal duodenum resection.


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Of these 34 patients, 13 underwent end-style duodenojejunostomy in which the end of the proximal duodenum was involved in the reconstruction, while the rest (21 patients) had side-style duodenojejunostomy where the side of the proximal duodenum was involved.

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The results showed that in patients who underwent end-style duodenojejunostomy, the rate of multivisceral resection was lower compared to those who had side-style duodenojejunostomy. The rate of delayed gastric emptying and intraperitoneal infections was also lower in patients who received end-style duodenojejunostomy.

More than a third (35.3%) of all patients had a major complication but no patient died during or after the operation due to complications. The incidence of major complications was similar between the 2 groups of patients with 3 out of 13 patients who underwent end-style duodenojejunostomy experiencing them compared to 9 out of the 21 who had side-style duodenojejunostomy.

The resection of the distal duodenum can sometimes be necessary for radical surgery to treat diseases such as GIST. It is important to restore duodenal continuity following such a procedure.

Reference

Liu W, Wang J, Ma L, et al. Which style of duodenojejunostomy is better after resection of distal duodenum. BMC Surg. 2022;22:409. doi:10.1186/s12893-022-01850-2