Takei Ryohei, Hashimoto Masashi, Zaimoku Ryosuke, Terakawa Hirohumi, Terada Itsuro, Tsukioka Yuji, Kiriyama Masato
Department of Surgery, Kurobe City Hospital, Kurobe, Toyama 938-8502, Japan.
J Surg Case Rep. 2020 Oct 9;2020(10):rjaa296. doi: 10.1093/jscr/rjaa296. eCollection 2020 Oct.
Conventional jejunal reconstruction procedures for large duodenal defects include jejunal serosal patch repair and duodenojejunostomy and have some risks of postoperative complications. The pedicled jejunal flap is used for reconstruction following laryngopharyngectomy, esophagectomy and other gastrointestinal surgeries. We report two cases of successful closure of duodenal defects after partial duodenectomies by pedicled jejunal flap reconstruction. Case 1: A 72-year-old man was diagnosed with gastrointestinal stromal tumor by esophagogastroduodenoscopy (EGD), endoscopic ultrasound-guided fine needle aspiration biopsy and computed tomography (CT). Case 2: A 63-year-old woman was diagnosed with early duodenal cancer using EGD and CT. Partial duodenectomy and pedicled jejunal flap reconstruction were performed in both patients. A part of the jejunum was formed into a pedicled flap to fit the duodenal defect and duodenojejunal anastomosis was performed. The patients did not report any postoperative gastrointestinal symptoms or abnormal findings during follow-up EGD or upper gastrointestinal radiography.
用于修复较大十二指肠缺损的传统空肠重建手术包括空肠浆膜补片修补术和十二指肠空肠吻合术，且存在一些术后并发症风险。带蒂空肠瓣用于喉咽切除术、食管切除术及其他胃肠手术后的重建。我们报告两例通过带蒂空肠瓣重建成功闭合部分十二指肠切除术后十二指肠缺损的病例。病例1：一名72岁男性经食管胃十二指肠镜检查（EGD）、内镜超声引导下细针穿刺活检及计算机断层扫描（CT）诊断为胃肠道间质瘤。病例2：一名63岁女性经EGD和CT诊断为早期十二指肠癌。两名患者均接受了部分十二指肠切除术和带蒂空肠瓣重建术。将一部分空肠制成带蒂瓣以适应十二指肠缺损，并进行十二指肠空肠吻合术。患者在随访EGD或上消化道造影检查期间未报告任何术后胃肠道症状或异常发现。
