Minimally invasive duodenojejunostomy for superior XXXX : a case series and review of the literature.

@entity1 @entity308 @entity353 @entity384 @entity391 @entity260 @entity281 @entity158 @entity6029
BACKGROUND: @entity6029 ( @entity6029 ) is a disorder characterized by vascular compression of the duodenum leading to mechanical obstruction. Surgical intervention is indicated in @entity1 who fail standard non-operative management, in which duodenojejunostomy is favored based on previous small series. Given the rarity of the condition, knowledge of the optimal indications for surgery, risk of @entity260 , and prognosis of @entity6029 after minimally invasive duodenojejunostomy is limited. METHODS: A retrospective chart review was performed on @entity1 who underwent minimally invasive duodenojejunostomy for @entity6029 from March 2005 to December 2013 at our "healthcare system". We analyzed @entity1 ' presentations, work-up, surgical therapy, and outcomes. RESULTS: A series of 14 @entity1 with @entity6029 underwent minimally invasive duodenojejunostomy. All of these @entity1 met clinical criteria of @entity6029 with radiological confirmation. Average @entity353 before surgery was 10.7  kg. @entity308 were comorbid in 6/14 @entity1 . The mean age was 39  years (19-91  years). Twelve operations were completed laparoscopically and two were performed with robotic assistance. Mean operation duration was 119  min and average length of hospital stay was 5.5  days. There were no immediate @entity260 . One @entity1 developed a delayed  anastomotic stricture that improved with single @entity384 . Initial symptom improvement occurred in all @entity1 and the improvement occurred in 11 @entity1 (79  %) during the follow-up. At a mean follow-up of 20  months, two @entity1 experienced complications, including one @entity281  at a simultaneously placed J-tube site and one @entity1 with dumping syndrome. Mean weight gain was 3.8  kg (p  <  0.01). CONCLUSION: @entity6029 should be considered a potential diagnosis in @entity1 who present with a history of @entity391 , @entity158 , and @entity353 and confirmatory radiographic findings. In well-selected @entity1 , minimally invasive duodenojejunostomy is a safe and effective treatment for @entity6029 with excellent short-term outcomes.
