Use of jejunal serosal patch and pyloric exclusion in the management of complex duodenal injury

We describe the techniques used in one case of complex duodenal trauma.TECHNIQUE: The duodenum is approached via a standard laparotomy with Kocherisation. Primary repair of the duodenal perforations is performed using a 3/0 polydioxanone suture (PDS), followed by mobilisation of a loop of mid-jejunum against the area of duodenal trauma over the primary repair as a jejunal serosal patch. The antimesenteric jejunal serosal border is sutured to the serosa of the duodenum (serosa only) using a 3/0 PDS. Pyloric exclusion is then performed through an anterior gastrostomy, to control the volume of gastric juice entering the duodenum. The pylorus is sutured closed using an absorbable suture followed by closure of the anterior gastrostomy using a GIA stapling device.PMID:38445581 | DOI:10.1308/rcsann.2023.0074
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Source Type: research