THREE CASES OF MUCOSAL JEJUNAL PATCHES WHICH WERE APPLIED FOR MASSIVE DUODENAL INJURY

概要

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This paper describes successful application of mucosal jejunal patches to massive injury to the duodenum due to a blunt abdominal trauma in three patients. The patients were 68-, 43- and 67-year-old men. All three patients had injuries accompanied by large defects in the descending, the third and postubulbar portion of the duodenum. A mucosal jejunal patch was produced by elevating the jejunum in Roux-en-Y fashion and creating side to side anastomosis. Subsequently, a 16 Fr. sump tube was inserted into the anastomosis for decompression. Whenever, there was a possibility of associated injury to the bile ducts, a cholangiogram was obtained, after which, a T-tube was inserted into the common bile duct for decompression. Even if the injured area is large, a mucosal jejunal patch can be used for surgically repairing massive duodenal injury. Because it also serves to directly decompress the repaired area, it is less invasive than more risky surgical procedures like pancreatoduodenectomy. The use of mucosal jejunal patches is a useful surgical technique in which serious postsurgical complications such as ruptured sutures do not occur, moreover, unlike more invasive surgical methods, pancreatic and digestive functions are much less likely to be impaired.
日本臨床外科学会の論文