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ORIGINAL ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 2  |  Page : 75-78

Retrocolic isoperistaltic gastrojejunostomy as an alternative to Kimura's duodenoduodenostomy in low- and very low-birth-weight babies of duodenal atresia: A 5 year retrospective study


Department of Pediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Abhaya Gupta
Department of Pediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Dr. Babasaheb Ambedkar Road, Sion West, Mumbai - 400 022, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcn.JCN_95_18

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Background: Duodenal atresia is a frequent occurrence in babies requiring emergent surgical intervention. Conventionally, Kimura's diamond duodenoduodenostomy has been considered as the gold standard. However, in low-birth-weight (LBW), very LBW (VLBW), and extremely LBW (ELBW) babies, we have found it to be a procedure that is not well tolerated and resulted in mortality. In these conditions, a retrocolic isoperistaltic gastrojejunostomy is well tolerated by patients. Most of the patients that public hospitals cater to are from the lower socioeconomic strata belonging to poor families, immigrant population, and daily wagers. Aim: The aim of the study is to evaluate gastrojejunostomy as an alternative to Kimura's duodenoduodenostomy in LBW, VLBW, and ELBW neonates having duodenal atresia without major cardiac malformations. Materials and Methods: We did a retrospective analysis of all patients with birth weight <2 kg operated for duodenal atresia in our institute in the last 5 years (2012–2017). Neonates having cardiac abnormality were excluded from the study. Patients were followed up regularly. Results: Out of 5 neonates operated for gastrojejunostomy, all survived postoperatively. Out of 4 neonates operated for Kimura's duodenoduodenostomy, none survived postoperatively. Most common cause of mortality was sepsis and anastomotic leak. Conclusion: In a setting of LBW and VLBW deliveries, gastrojejunostomy is a good alternative to duodenoduodenostomy achieving favorable results.


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