Tang Huajian,Zheng Jintao,Li Weiliao,et al.Efficacies of modified diamondshaped anastomosis for neonatal annular pancreas.[J].Journal of Clinical Pediatric Surgery,,17():542-546.
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Efficacies of modified diamondshaped anastomosis for neonatal annular pancreas.

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第17卷 Number: 2018 07 Page: 542-546 Column: 论著 Date of publication: 2018-07-28
Author(s):
Tang Huajian1; Zheng Jintao1; Li Weiliao1; Huang Zhenqiang1; Yu Zhi1; Liu Guoqing1; Liu Weidong2.
1.Department of Pediatric Surgery;
Keywords:
Pancreas;  Intestinal Obstruction;  Surgical Procedures; Operative;  Infant; Newborn
Document code:
A
Abstract:
ObjectiveTo explore the efficacies of modified diamondshaped anastomosis for annular pancreas in newborns.MethodsRetrospective analyses were performed for the clinical data of 19 newborns with annular pancreas during January 2011 to October 2016.There were 11 boys and 8 girls.They were premature (n=6) and fullterm (n=13).The average weight was 2 785(1 760~3 675) grams.Prenatal ultrasound revealed a double bubble sign in 13 cases.Upper gastrointestinal iodized oil angiography detected duodenal obstruction in all of them.Lower digestive tract contrast examination were performed in 10 cases.And 7/10 cases eliminated intestinal malrotation and 4/10 microcolon.One case had multiple malformations with anal atresia,atrial septal defect and congenital pulmonary hypoplasia.Modified diamondshaped anastomosis was performed.Dilated proximal duodenum was dissected in a transverse vshaped incision and distal microduodenum accessed longitudinally for 2 cm.ResultsThe average surgical duration was (87±35)(56~168) min and the average intraoperative bleeding volume (6±5) (3~15) mL.There was no blood transfusion.The average postoperative fasting lasted (7±3)(5~10) days.And the average hospitalization stay was (19±14)(3~48) days.There was 1 case of incision infection.Another case of multiple malformations was abandoned by his parents at Day 1 postoperation.The remainder recovered.Postoperative upper gastrointestinal angiography at Day 12~14 showed no anastomotic stenosis or fistula.ConclusionAnnular pancreas is not a common neonatal gastrointestinal tract malformation and diamondshaped anastomosis is a major therapy.Modified diamondshaped anastomosis has excellent outcomes.It may enlarge anastomosis and reduce anastomotic tension so as to prevent the occurrence of anastomotic stenosis and fistula.Multiple malformations are the major prognostic factors.
Last Update: 2018-07-24