Is pyloric exclusion the best surgery for lesions of the duodenum D3 and D4?

Abstract

Due to its retroperitoneal location, injuries to the duodenum are relatively rare. As a result, many general surgeons have limited experience of duodenal trauma, which is particularly the case in countries with a small population. The use of primary repair in the treatment of duodenal injuries is rising with the existing trend of a move away from surgical treatment towards less invasive procedures, and the role of pyloric exclusion has become controversial. We present two cases with lesions to D3 and D4 of the duodenum, treated by pyloric exclusion.