Application of suspension traction in laparoscopic suture anastomosis of duodenum

Abstract

Objective To explore the application value of suspension traction in laparoscopic suture anastomosis of duodenum. Methods Retrospective analyses were conducted for the clinical data of 42 cases with congenital duodenal obstruction (CDO). They were divided into groups A and B according to whether or not suspension traction was applied. Group A (convention, n=13): duodenal membrane atresia (n=7) and annular pancreas (n=6); Group B (suspension traction, n=29): duodenal membrane atresia (n=16), duodenal atresia Ⅱ type (n=3) and annular pancreas (n=10). Three laparoscopic holes were employed in all cases to compare operative duration, number of conversion into open surgery, postoperative stomal leak, anastomotic stenosis, feeding start time and full feeding time, etc. Results Comparing Groups A and B, the operative duration for vertical incision of anterior duodenum plus a transverse suture was(87.3±13.2)vs (77.1±11.5) min and diamond-shaped side-to-side anastomosis (135.7±20.8) vs (77.1±11.5) min. In Group A, there were conversion into open surgery (n=2), anastomotic fistula cured by conservative drainage (n=1) and repeated emesis cured conservatively (n=1). Neither conversion into open surgery nor complication occurred during or after operation. Conclusions The application of suspension traction provides excellent exposure and operative convenience in laparoscopic suture anastomosis of duodenum. And operative difficulty is reduced with shortened time and enhanced safety. Key words: Laparoscopes; Neonate; Duodenum; Pancreas