Ileal Flap Duodenoplasty to Repair Large Duodenal Defects after R0 Resection for Malignant Tumor to Avoid a Complex Reconstruction: Experience with 6 Cases

Sami Hamed, TheophileGuilbaud, Jean Hardwigsen and Yves Patrice Le Treut

Department of Digestive Surgery and Liver Transplantation, Aix Marseille University, France

^*Correspondance to: Yves Patrice Le Treut 

 PDF  Full Text DOI: 10.25107/2474-1647.2110

Abstract

Locally advanced malignant abdominal tumors of the right upper quadrant, as in colonic carcinomas, can lead to a major resection of the duodenal sidewall to create free resection margins (R0 resection). There is no standard surgical technique to manage this duodenal defect. We report here our experience of a standardized duodenal reconstruction using an ileal flap. Following a right colectomy with a major duodenal resection, the duodenal defect was covered with a pedicledileal flap using the terminal ileum. This reconstruction is particularly suitable for performing a tensionfree ileo-transverse anastomosis. Duodenal leakage did not occur in our study. Our experience as well as a literature review shows that this technique is feasible and safe and is a reliable surgical approach that avoids the need for a radical pancreaticoduodenectomy or a non-anatomical by-pass.

Keywords

Locally advanced tumors; Large duodenal defect; Ileal flap

Cite the article

Hamed S, Guilbaud T, Hardwigsen J, Le Treut YP. Ileal Flap Duodenoplasty to Repair Large Duodenal Defects after R0 Resection for Malignant Tumor to Avoid a Complex Reconstruction: Experience with 6 Cases. Clin Surg. 2018; 3: 2110.