BACKGROUND: The duodenal damage occurs in about 3% to 12% of patients with abdominal traumas. The suture of this wound and local drainage is the most common treatment in minor injuries. The challenge remains choosing the best option to treat larger wounds. The closing of the pylorus and the deviation of the digestive transit through a gastrojejunal anastomosis is the most frequent choice in these situations. The objectives of this study were to observe the differences between the time of the pyloric reopening after the occlusion with different suture material and the influence of vagotomy on the local tissue changes. METHODS: Thirty rats were studied and submitted to the closure of the gastroduodenal pylorus and gastrojejunal anastomosis. The animals were divided into three groups (n = 10), according to the type of suture material: plain catgut, polyglycolic acid and polypropilene. Half of the animals in each group (n = 5) were submitted to a troncular vagotomy as well. The studies after the operations consisted of abdominal x-ray following intragastric injection of contrast, on a weekly basis until the gastroduodenal transit has been established or during a maximum period of four weeks. At the end of the study, pyloric region and the gastrojejunal anastomosis were removed for histological analysis. The comparison among the groups were performed by the Kaplan-Meier test, with significance for p<0.05. RESULTS: Polypropilene suture maintained the pyloric closure during a longer period (36.3 ± 11.6 days) (p <0.05). There were no differences between the polyglicolic acid suture (25.8 ± 14.2 days) and the plain categut suture (18.7 ± 10.2 days). The vagotomy did not influence the time of the pyloric re-opening, but was associated to less gastric inflammatory reaction. CONCLUSION: The inabsorbable suture was the most adequate for the exclusion of the pyloric transit and the vagotomy had no influence in the time of the re-opening of the pylorus, but reduced the gastric inflammation.
Duodenum; Pylorus; Vagotomy; Radiology; Rats
