Abstract

PIERRO, André Canesso et al. Treatment of complex duodenal lesions: comparison between simple repair and repair associated to pyloric exclusion and gastrojejunostomy in dogs. Acta Cir. Bras. [online]. 2005, vol.20, n.1, pp. 28-35. ISSN 1678-2674.  http://dx.doi.org/10.1590/S0102-86502005000100006.

PURPOSE: The goal of this study is to compare the results of two different procedures to complex duodenal lesion (grade III), in an animal model. METHODS: Twenty-four mongrel dogs, weighting 10 to 15 kg, were distributed in 4 groups of 6 animals each. All animals were submitted to a complex duodenal lesion (grade III), with a 50% loss of its circumference. All animals were treated with a longitudinal repair, resulting a significant narrowing of the duodenal lumen. Groups A and C animals were submitted solely to repair while groups B and D, also underwent pyloric exclusion and gastrojejunostomy as a protection method. Groups A and B animals were sacrificed at day 7 post op, while groups C and D were sacrificed at day 14. The following parameters were studied: weight-loss, degree of duodenal stenosis, operative site, vomiting, anastomotic leak, intra-abdominal abscess formation and death. RESULTS: The results obtained with simple duodenal repair were superior to pyloric exclusion and gastrojejunostomy in that the animals lost less weight and vomited less. It was also a simpler and less traumatic procedure. There were no differences in duodenal stenosis, leak, intra-abdominal abscess incidence or death between the two treatment groups. CONCLUSION: Duodenal suture associated to pyloric exclusion and gastrojejunostomy resulted more weight-loss and more vomiting incidence; the healing process of the duodenal suture line were similar between the two treatments; both treatments resulted similar increase in the duodenal stenosis degree; there were no cases of suture dehiscence, anastomotic leak, intra-abdominal abscess or death related to the kind of treatment; all animals submitted to pyloric occlusion had it intact at the time of necropsis.

Keywords : Duodenal lesions; Pyloric exclusion; Experimental surgery.