Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | sâmbătă, 16 februarie 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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DISINSERTION OF DUODENAL PAPILLA DURING DUODENAL SURGERY – 20 YEARS AFTER SURGICAL REPAIR
V. Șurlin, E. Georgescu, Milena Georgescu, S. Săndulescu, I. Georgescu
1st Clinic of Surgery, Clinic Emergency Hospital of Craiova
University of Medicine and Pharmacy of Craiova
Jurnalul de chirurgie 2010; 6 (4): 524-529
Full text:
Format PDF (Engleză/English)

Abstract:

The authors present the case of a 68 years old patient admitted for chronic calculous cholecistitis and symptomatic choledocolithiasis with obstructive jaundice and moderate biochemical cholestasis. The patient had a Reichel-Polya gastric resection for ulcer 20 years ago with disinsertion of duodenal papilla repaired with jejunal loop patch in “Roux en Y”. Intraoperatively we noticed chronic sclerous acalculous cholecistitis, equivalence of cholecisto-choledocal fistula, choledocolithiasis. Exploration of the duodenal papilla identified a relative oddian stenosis. The first and second parts of duodenum were absent and replaced by a jejunal loop in “Roux en Y” patching the papilla on the side, with a free blind end and anastomosed laterally to the gastric stump. The second, subvaterian part of duodenum have been closed and left blind. The treatment of the common bile duct lithiasis consisted in cholecistectomy with primary closure of the large communication between the gallbladder and common bile duct, coledocolithotomy, common bile duct (CBD) lavage. To ensure an adequate biliary flow we decided for a side-to-side anastomosis between the CBD and the blind part of the jejunal Roux-en-Y loop. The blind end of the second subvaterian part of the duodenum was anastomosed in an end-to-end fashion also to the blind end of the jejunal Roux-en-Y- loop to ensure some biliary flow through remaining part of the duodenum. The postoperative course was simple. At 2 years of follow-up the patient is free of symptoms.

KEY WORDS: PAPILLA DISINSERTION, ROUX-EN-Y, STENOSING PAPILLITIS

Correspondence to: Dr. Valeriu Șurlin, address: Calea București 34, A8b, 3/10, 200484 Craiova, Dolj, Romania, telephone: +40251502174, e-mail: .



: Creative Commons License
Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.