[Treatment of complex duodenal lesions: comparison between simple suture and suture with pyloric exclusion and gastrojejunostomy in dogs].

PURPOSE

The goal of this study is to compare the results of two different procedures to complex duodenal lesion (grade III), in an animal model.

METHODS

Twenty-four mongrel dogs, weighting 10 to 15 kg, were distributed in 4 groups of 6 animals each. All animals were submitted to a complex duodenal lesion (grade III), with a 50% loss of its circumference. All animals were treated with a longitudinal repair, resulting a significant narrowing of the duodenal lumen. Groups A and C animals were submitted solely to repair while groups B and D, also underwent pyloric exclusion and gastrojejunostomy as a protection method. Groups A and B animals were sacrificed at day 7 post op, while groups C and D were sacrificed at day 14. The following parameters were studied: weight-loss, degree of duodenal stenosis, operative site, vomiting, anastomotic leak, intra-abdominal abscess formation and death.

RESULTS

The results obtained with simple duodenal repair were superior to pyloric exclusion and gastrojejunostomy in that the animals lost less weight and vomited less. It was also a simpler and less traumatic procedure. There were no differences in duodenal stenosis, leak, intra-abdominal abscess incidence or death between the two treatment groups.

CONCLUSION

Duodenal suture associated to pyloric exclusion and gastrojejunostomy resulted more weight-loss and more vomiting incidence; the healing process of the duodenal suture line were similar between the two treatments; both treatments resulted similar increase in the duodenal stenosis degree; there were no cases of suture dehiscence, anastomotic leak, intra-abdominal abscess or death related to the kind of treatment; all animals submitted to pyloric occlusion had it intact at the time of necropsis.